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目的:比较不同抗凝策略在马蜂蜇伤患者连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)中的应用效果及护理对策。方法:回顾性分析我科31例马蜂蜇伤患者,93次CRRT治疗时分别采用无肝素、局部肝素抗凝、低分子肝素钠抗凝的治疗方案,观察3组患者CRRT治疗过程中滤器使用时长、静脉壶凝血程度、有无活动性出血,根据不同的抗凝方式开展针对性护理。结果:无肝素组滤器使用时长与其他2组差异有统计学意义(P<0.05)。3个组别之间静脉管路凝血严重程度差异具有统计学意义(P=0.000)。无肝素组发生1次因体外凝血导致无法回血情况。3组发生活动性出血情况差异具有统计学意义(P=0.017)。结论:CRRT治疗马蜂蜇伤时应根据患者病情采用个性化抗凝护理,从而减少或避免意外凝血及出血相关并发症的发生,使CRRT发挥最大治疗效果。
Objective: To compare the effects and nursing strategies of different anticoagulation strategies in the treatment of continuous renal replacement therapy (CRRT) in stinger wasps. Methods: A retrospective analysis of 31 cases of stings wasps in our department were 93 cases of CRRT were treated with non-heparin, local heparin anticoagulation, low molecular weight heparin anticoagulant treatment were observed CRRT treatment in the three groups during the use of filters , Venous pot coagulation level, with or without active bleeding, according to different anticoagulation methods to carry out targeted care. Results: There was a significant difference between the two groups in the length of filter without heparin (P <0.05). There was a significant difference in the severity of coagulation between the three groups (P = 0.000). In the non-heparin group, blood was unable to return to blood due to in vitro coagulation. The difference of active bleeding in 3 groups was statistically significant (P = 0.017). Conclusion: CRRT treatment should be based on individual patients with stomatitis stab sting care, thereby reducing or avoiding accidental coagulation and bleeding-related complications, so that CRRT maximum therapeutic effect.