發(fā)布時(shí)間：2018-10-25 13:23

【摘要】：目的探討不同抗凝方法對(duì)連續(xù)性血液凈化治療膿毒癥患者凝血功能和療效的影響。方法 120例膿毒癥患者均行連續(xù)性靜脈-靜脈血液濾過(CVVH)治療,其中有活動(dòng)性出血者60例行無肝素治療(無肝素組),有出血傾向者60例采用低分子肝素抗凝(肝素組)。兩組治療前及治療后1、2 d檢測(cè)尿素氮(BUN)、血肌酐(Scr)、血小板(PLT)、凝血酶原時(shí)間(PT)、活化部分凝血活酶時(shí)間(APTT)、凝血酶時(shí)間(TT)、國際標(biāo)準(zhǔn)化比值(INR)和纖維蛋白原(Fg),并于治療后3 d采用急性生理學(xué)和慢性健康狀況評(píng)分系統(tǒng)(APACHE)Ⅲ評(píng)估健康狀況,依據(jù)APACHEⅢ預(yù)測(cè)死亡率并統(tǒng)計(jì)28 d存活率。結(jié)果兩組治療后BUN、Scr水平較治療前均明顯降低(P0.05),但組間無顯著差異(P0.05);PLT、PT、APTT、TT、INR和Fg水平較治療前均明顯降低(P0.05),但組間無顯著差異(P0.05);APACHEⅢ評(píng)分、死亡率和28 d存活率均無顯著性差異(P0.05)。結(jié)論連續(xù)性血液凈化能夠改善膿毒癥患者凝血功能,不同抗凝方法對(duì)連續(xù)性血液凈化治療膿毒癥患者的凝血功能和療效影響不明顯。
[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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