不同抗凝策略在马蜂蜇伤患者CRRT治疗中的应用及护理

发布时间：2018-06-10 12:58

本文选题：连续性肾脏替代治疗 + 马蜂蜇伤　；参考：《重庆医科大学学报》2017年09期

【摘要】：目的:比较不同抗凝策略在马蜂蜇伤患者连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)中的应用效果及护理对策。方法:回顾性分析我科31例马蜂蜇伤患者,93次CRRT治疗时分别采用无肝素、局部肝素抗凝、低分子肝素钠抗凝的治疗方案,观察3组患者CRRT治疗过程中滤器使用时长、静脉壶凝血程度、有无活动性出血,根据不同的抗凝方式开展针对性护理。结果:无肝素组滤器使用时长与其他2组差异有统计学意义(P0.05)。3个组别之间静脉管路凝血严重程度差异具有统计学意义(P=0.000)。无肝素组发生1次因体外凝血导致无法回血情况。3组发生活动性出血情况差异具有统计学意义(P=0.017)。结论:CRRT治疗马蜂蜇伤时应根据患者病情采用个性化抗凝护理,从而减少或避免意外凝血及出血相关并发症的发生,使CRRT发挥最大治疗效果。
[Abstract]:Objective: to compare the effects and nursing strategies of different anticoagulant strategies in continuous renal replacement therapy for hornet stings. Methods: a total of 31 hornet sting patients were treated with CRRT without heparin, local heparin anticoagulant and low molecular weight heparin sodium respectively. According to different ways of anticoagulant nursing care was carried out according to the degree of coagulation and active bleeding in venous jug. Results: there was significant difference between the two groups in the length of the filter used in the heparin group and the other two groups (P 0.05). The severity of venous coagulation in the three groups was significantly different from that in the other two groups (P = 0.000). In the group without heparin, there was a significant difference in the incidence of active bleeding in group 3 due to blood coagulation in vitro, and there was a significant difference in the incidence of active bleeding in group 3 (P < 0.017). Conclusion individualized anticoagulant nursing should be used in the treatment of hornet stings by the use of specific anticoagulant nursing in order to reduce or avoid the occurrence of accidental coagulation and bleeding related complications, so that CRRT can exert the maximum therapeutic effect.
【作者单位】：重庆医科大学附属第二医院肾内科;重庆市中医院药物临床实验机构办公室;
【基金】：重庆市卫生计生委医学科研资助项目(编号:2016ZDXM008)
【分类号】：R473.6

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