密闭式自动排气管路预冲法在血液透析患者中的应用

摘要

目的 观察密闭式自动排气管路预冲法在血液透析患者中的临床应用效果.方法 选取海南省人民医院71例血液透析患者,采用自身前后对照试验,分为对照组和试验组,对照组使用常规密闭式管路预冲法,试验组使用密闭式自动排气管路预冲法,比较两组的预冲操作时间及透析器凝血情况;对32例使用具有在线尿素清除指数监测功能的透析机行透析治疗的患者(按入院时间随机安排),计算并比较两组尿素清除指数Kt/V值;比较随机选取20例患者的体外血液循环通路中不溶性微粒的清除效果.结果 试验组预冲操作时间(221.69±10.44)s明显少于对照组预冲操作时间(367.88±16.68)s,差异有统计学意义(t=75.05,P<0.001),两组的透析器凝血分级情况相比无明显差异(Z=-0.16,P=0.87);试验组尿素清除指数Kt/V为(15.08±1.53),与对照组的(15.03±1.55)相比无明显差异(t=-0.31,P=0.76);外循环血液通路内不溶性微粒直径>10μm及>25μm的数量,试验组与对照组比较均无统计学意义.结论 密闭式自动排气管路预冲法对血液透析患者可能是一种省时节力、安全有效的方法,值得在临床推广应用.%Objective To observe the application effect of closed automatic-exhaust pipeline pre-rinse method in hemodialysis patients.Methods 71 cases of hemodialysis patients from Hainan provincial people's hospital were collected. By using the self-control study, they were divided into control group and experimental group. Control group used conventional closed pipeline pre-rinse while experimental group used closed automatic-exhaust pipeline pre-rinse. Pre-rinse operation time and dialyser coagulation of the two groups were compared. Urea clearance index Kt/V in two groups of 32 patients who used dialysis machine with on-line urea clearance index monitoring function (arranged according to the admission time) were calculated and compared. 20 patients were randomly selected to compare removal effect of particulate matter in extracorporeal blood circulation pathway.Results Pre-rinse operation time in experimental group was (221.69±10.44) s which was less than control group (367.88±16.68) s, the difference was statistically significant (t=75.05, P<0.001). Coagulation grade of dialyser between the two groups had no statistically significant difference (Z=-0.16,P=0.87). Urea clearance index Kt/V in experimental group was (15.08±1.53) and control group was (15.03±1.55), the difference was no statistically significant (t=-0.31,P=0.76). Number of particulate matter >10μm and >25 μm in extracorporeal blood circulation pathway between the two groups were compared, and the difference was not statistically significant.Conclusions For hemodialysis patients, closed automatic-exhaust pipeline pre-rinse maybe a time saving and power saving, safe and effective method, worthy to popularize and apply in clinic.