论文部分内容阅读
目的探讨血液灌流(hemoperfusion,HP)对急性毒物中毒患者凝血功能的影响。方法急性毒物中毒患者32例均在洗胃、导泻、利尿及对症支持等常规治疗基础上行HP治疗,分别于第1次行HP前及行HP治疗后1,2h检测凝血酶原时间(prothrombin time,PT),部分凝血酶原时间(activated partial thromboplastin time,APTT),凝血酶原时间的国际正常化比率(international normalized ratio,INR)、纤维蛋白原(fibrinogen,FIB),D-二聚体(D-dimer,D-D)及血小板计数(platelet,PLT),并观察患者出血情况。结果 HP治疗1,2h时PLT均低于治疗前(P<0.05),治疗2h时PLT较治疗1h时增高(P<0.05);HP治疗2h时D-D水平与治疗前比较差异有统计学意义(P<0.05);HP治疗1,2h时PT,APTT,INR,FIB与治疗前比较差异均无统计学意义(P>0.05);治疗过程中发生透析导管处渗血2例,消化道出血1例,血尿1例,口腔出血1例,皮肤大片瘀斑1例。结论 HP治疗可导致患者血小板计数下降,不影响其他凝血功能。
Objective To investigate the effect of hemoperfusion (HP) on the coagulation function in patients with acute poisoning. Methods 32 cases of acute poisoning patients were treated with HP on the basis of routine therapy such as gastric lavage, catharticure, diuresis and symptomatic support. Prothrombin time (prothrombin time (PT), activated partial thromboplastin time (APTT), the international normalized ratio (INR) of prothrombin time, fibrinogen (FIB), D-dimer (D-dimer, DD) and platelet (PLT) were measured. The bleeding was observed. Results The PLT of HP at 1 h and 2 h was lower than that before treatment (P <0.05), PLT at 1 h was higher than that at 1 h after treatment (P <0.05), while DD at 2 h after HP treatment was significantly different from that before treatment P <0.05). There were no significant differences in PT, APTT, INR and FIB between the two groups at 1 and 2 h after HP treatment (P> 0.05). During the course of treatment, bleeding in dialysis catheter occurred in 2 cases and gastrointestinal bleeding in 1 Cases, hematuria in 1 case, oral bleeding in 1 case, large skin ecchymosis in 1 case. Conclusion HP therapy can lead to a decrease in platelet count without affecting other coagulation functions.