| 边双双,张萍,陈江华.连续性血液净化对脓毒症患者凝血功能及临床疗效的研究[J].浙江中西医结合杂志,2014,24(1): |
| 连续性血液净化对脓毒症患者凝血功能及临床疗效的研究 |
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| 投稿时间：2013-07-22 修订日期：2013-11-18 |
| DOI： |
| 中文关键词: 连续性血液净化 脓毒症 凝血功能 急性肾损伤 无肝素 低分子肝素 |
| 英文关键词:Continuous blood purification (CBP) Sepsis Coagulation Acute kidney injury Non-heparin Low molecular weight heparin |
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| 中文摘要: |
| 【】 目的 对连续性血液净化治疗时不同抗凝方法对脓毒症患者凝血功能的影响及临床疗效进行研究与探讨。方法 回顾性分析接受CBP治疗的75例脓毒症患者的临床资料。根据抗凝方式的不同分为无肝素组和低分子肝素组,了解原发病构成,感染部位,CVVH治疗剂量和治疗时间,治疗前和治疗后24h、48h统计BUN、Scr、WBC、PLT、PT、APTT、TT、INR、Fg等,并分析CVVH治疗对患者预后的影响。结果 CVVH治疗后,无肝素组和低分子肝素组BUN、Cr均有明显下降(P<0.01),但两组差异没有明显的统计学意义。两组病死率均明显低于根据APACHEⅢ预测的死亡率。CVVH治疗后,两组PLT值、PT值、APTT值、TT值、INR值、Fg值均比治疗前降低,两组差异没有明显的统计学意义。结论 无肝素抗凝CBP治疗与低分子肝素抗凝CBP治疗改善凝血系统不仅仅是由于抗凝,而无肝素抗凝可能并不会增加机体凝血功能的异常且可能并不一定会增加PLT的消耗。 |
| 英文摘要: |
| 【】Objective To study the effect and clinical outcome of CBP treatment with different anticoagulant ways to the coagulation function in patients with sepsis. Methods Seventy-five sepsis patients treated with CBP were divided into non-heparin group and the low molecular weight heparin group. The composition of the primary disease, site of infection and CVVH treatment dose and treatment time were studied.The?kidney function and anticoagulant function of these patients before and 24h, 48h after treatment and changes in clinical indicators were analyzed. Results After CVVH treatment, the BUN, Cr of no heparin group and the low molecular weight heparin group were both decreased, but the change between groups was not statistically significant. The PLT value, PT values, APTT values, TT values, INR values and Fg values ??were lower than those of before CVVH treatment, but there was no statistical difference between the groups. Conclusions CBP treatment can effectively improve the coagulation system function in both the no heparin group and the low molecular weight heparin group and the improvement of the coagulation system function by CBP treatment was not sole because of anticoagulant.CBP treatment without heparin did not increase blood coagulation dysfunction and the consumption of PLT. |
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