不同抗凝方法对连续性血液净化治疗脓毒症患者凝血功能和疗效的影响

发布时间：2018-10-25 13:23

【摘要】：目的探讨不同抗凝方法对连续性血液净化治疗脓毒症患者凝血功能和疗效的影响。方法 120例脓毒症患者均行连续性静脉-静脉血液滤过(CVVH)治疗,其中有活动性出血者60例行无肝素治疗(无肝素组),有出血倾向者60例采用低分子肝素抗凝(肝素组)。两组治疗前及治疗后1、2 d检测尿素氮(BUN)、血肌酐(Scr)、血小板(PLT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、国际标准化比值(INR)和纤维蛋白原(Fg),并于治疗后3 d采用急性生理学和慢性健康状况评分系统(APACHE)Ⅲ评估健康状况,依据APACHEⅢ预测死亡率并统计28 d存活率。结果两组治疗后BUN、Scr水平较治疗前均明显降低(P0.05),但组间无显著差异(P0.05);PLT、PT、APTT、TT、INR和Fg水平较治疗前均明显降低(P0.05),但组间无显著差异(P0.05);APACHEⅢ评分、死亡率和28 d存活率均无显著性差异(P0.05)。结论连续性血液净化能够改善脓毒症患者凝血功能,不同抗凝方法对连续性血液净化治疗脓毒症患者的凝血功能和疗效影响不明显。
[Abstract]:Objective to investigate the effect of different anticoagulant methods on coagulation function and efficacy of continuous blood purification in septic patients. Methods 120 patients with sepsis were treated with continuous veno-venous hemofiltration (CVVH). 60 patients with active hemorrhage were treated with no heparin (no heparin group) and 60 patients with bleeding tendency were treated with low molecular weight heparin anticoagulation (heparin group). Blood urea nitrogen (BUN), creatinine (Scr), thrombin time (PT), partial thromboplastin time (APTT), thrombin time (TT),) and fibrinogen (Fg), (Fg),) were measured before and 1 day after treatment in both groups. D the acute physiology and chronic health status scoring system (APACHE) 鈪，

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