引用本文:李桂凤,韦彩花,文跃莲.[cn_title][J].[journal_cn_name],2019,[volume]([issue]):276-279.[点击复制]
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无肝素改良预冲排气法在人工肝支持系统无 肝素血浆置换中应用的效果评价
李桂凤,韦彩花,文跃莲
0
(广西中医药大学附属瑞康医院肝病科)
摘要:
目的 评价无肝素改良预冲排气法在人工肝支持系统无肝素血浆置换中应用的效果。方法选取2016年1月至12月在广西中医药大学附属瑞康医院肝病科治疗的肝衰竭患者100例为研究对象。根据不同的血浆置换预冲方式将患者分为观察组和对照组。观察组采用无肝素改良式预冲排气法;对照组采用常规预冲排气方法。比较两组患者血浆置换治疗前后血常规、肝肾功能、凝血功能指标,以及血浆分离器、管路凝血情况和治疗中出现的不良反应。结果两组患者血浆置换后总胆红素、直接胆红素、血尿素氮和血肌酐均显著下降(P<0.05),两组下降差值比较差异无统计学意义(P>0.05);血浆置换前后血常规和凝血功能指标变化值差异也无统计学意义(P>0.05)。观察组出现了12次血浆分离器和管路Ⅰ级凝血,对照组出现了7次血浆分离器和管路Ⅰ级凝血,两组差异无统计学意义(P>0.05);观察组患者血浆置换过程中不良反应发生率低于对照组(P<0.05)。结论无肝素改良预冲排气法不影响患者血常规、肝肾功能和凝血指标,但能够降低血浆置换过程中的不良反应发生率。
关键词:  肝素  改良预冲排气法  血浆置换  人工肝支持系统  肝衰竭
DOI:
基金项目:广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z20170744)
Effect of heparin free improved preflush exhaust method on the exchange of plasma in artificial liver support system
李桂凤,韦彩花,文跃莲
(Department of liver disease of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, China)
Abstract:
ObjectiveTo explore the effect of heparinfree improved preflush exhaust method on the plasma exchange with heparinfree in artificial liver support system. MethodsOne hundred patients with liver failure who were treated in Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine from January to December 2016 were selected and divided into observation group and control group according to different preflush methods. The separators and the vascular pathways were flushed by the method of improved preflush and exhaust (observation group) and routine preflush and exhaust methods (control group) respectively. Pre and posttreatment the blood routine, hepatic and renal function, coagulation function indexes,the coagulation of plasma separator and pipeline as well as adverse reactions were compared between the two groups. Results The total bilirubin, direct bilirubin, urea nitrogen and creatinine in the two groups were significantly decreased after the treatment (P<0.05). There was no significant difference between the two groups on the results of blood routine examination and coagulation function indexes (P>0.05).There were 12 times of plasma separator and pipeline grade I coagulation in the observation group, and 7 times of plasma separator and pipeline grade I coagulation in the control group which showed no significant difference between the two groups (P>0.05). The incidence rate of adverse reactions in the observation group was significantly lower than that in the control group (P<0.05). ConclusionsThe heparinfree improved preflush exhaust method does not affect the blood routine, hepatic and renal function and coagulation index of patients,which significantly reduces the incidence rate of adverse reactions.
Key words:  Heparin  Improved preflush exhaust method  Plasma exchange  Artificial liver support system  Liver failure

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