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[目的]观察低分子肝素作为抗凝剂在急性中毒血液灌流中的效果。[方法]将浙江省临海市第二人民医院2008年11月至2013年12月收治的急性中毒患者随机分成普通肝素组和低分子肝素组,每组60例,观察并比较两组血液灌流前后凝血功能(APTT、PT、TT)、血小板(PLT),灌流器及管路凝血、机体出血情况。[结果]低分子肝素组治疗前后PLT、APTT、PT、TT无明显变化(P均>0.05),普通肝素组治疗后PLT减少,APTT、PT、TT延长,差异均有统计学意义(P均<0.05)。管路凝血发生率:普通肝素组11.67%,低分子肝素组1.67%;出血发生率:普通肝素组18.33%,低分子肝素组5.00%。组间比较差异均有统计学意义(P均<0.05)。[结论]低分子肝素在血液灌流时抗凝作用强而不易引起出血,是首选抗凝药物,并且无需在灌流后常规做凝血功能检测。
[Objective] To observe the effect of low molecular weight heparin as anticoagulant in acute poisoning hemoperfusion. [Methods] Acute poisoning patients from Nov. 2008 to Dec. 2013 in Linhai Second People’s Hospital of Zhejiang Province were randomly divided into unfractionated heparin group and low molecular weight heparin group, with 60 cases in each group. Before and after hemoperfusion Coagulation function (APTT, PT, TT), platelet (PLT), perfusion and pipeline coagulation, body bleeding. [Results] There was no significant change in PLT, APTT, PT and TT before and after treatment in low molecular weight heparin group (all P> 0.05), PLT decreased, APTT, PT, TT prolonged after treatment in UFH group (P < <0.05). The incidence of coagulation in the pipeline was 11.67% in the unfractionated heparin group and 1.67% in the low molecular weight heparin group. The incidence of hemorrhage was 18.33% in the unfractionated heparin group and 5.00% in the low molecular heparin group. The difference between the two groups was statistically significant (P <0.05). [Conclusion] Low molecular weight heparin is the anticoagulant drug of choice for anticoagulation when hemoperfusion is perfunctory, and it is not necessary to perform routine coagulation tests after perfusion.