摘要
目的分析双重血浆分子吸附(Double plasma molecular adsorption system,DPMAS)联合血浆置换(Plasma exchange,PE)治疗肝衰竭过程中常见的操作报警发生情况及其影响因素。方法收集2019年1月1日-2020年12月31日期间新疆医科大学第一附属医院进行DPMAS联合PE治疗的肝衰竭患者共127例次,统计治疗过程中发生操作报警的常见类型、报警率、报警时间段及其影响因素。结果DPMAS联合PE治疗的127例次患者中,滤器前压(PBE)报警32例(25.2%),静脉压(PV)报警23例(18.1%),动脉压(PA)报警23例(18.1%),跨膜压(TMP)报警22例(17.3%),超滤压(PD2)报警2例(1.6%),气泡报警2例(1.6%)。PBE报警中在治疗50~70 min发生23例(71.9%),PA报警中在治疗时间≤30 min发生19例(82.6%)。年龄、性别、体重指数(BMI)、血小板(PLT)、凝血酶原时间(PT)、凝血酶原活动度(PTA)、国际标准化比率(INR)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)、股静脉置管时间在PBE报警组与PBE未报警组之间差异均无统计学意义(P>0.05),血小板、PT、PTA在PV报警组与PV未报警组之间差异有统计学意义(P<0.05),年龄、性别、BMI、INR、FIB、APTT、股静脉置管时间在PV报警组与PV未报警组之间差异均无统计学意义(P>0.05)。结论肝衰竭患者使用DPMAS联合PE治疗时,PA报警易发生在起始30 min内,而PBE报警则更易发生在治疗1h左右,PV报警与患者血小板计数及凝血功能中的PT、PTA有关。
Objective To analyze the common operational alarm and its influencing factors in the treatment of liver failure by double plasma molecular adsorption system(DPMAS)combined with plasma exchange(PE).Methods a total of127 patients of liver failure treated with DPMAS and PE that were collected from January 1,2019 to December 31,2020.The alarm types,alarm rate,alarm time period and influencing factors of operation alarm were statistically analyzed.Results among the 127 cases of DPMAS combined with PE,32 cases(25.2%)had pre filter pressure(PBE),23 cases(18.1%)had venous pressure(PV),23 cases(18.1%)had arterial pressure(PA),22 cases(17.3%)had transmembrane pressure(TMP),2 cases(1.6%)had ultrafiltration pressure(PD2)and 2 cases(1.6%)had bubble pressure.In PBE alarm,23 cases(71.9%)occurred within 50~70 min of the treatment,and in PA alarm,19 cases(82.6%)occurred within 30 min of the treatment.There were no significant differences in age,gender,body mass index(BMI),platelet count(PLT),Prothrombin time(PT),prothrombin activity(PTA),international standard ratio(INR),fibrinogen(FIB),activated partial thromboplastin time(APTT)and femoral vein catheterization time between PBE alarm group and PBE non alarm group(P>0.05).There were significant differences in platelet,Pt and PTA between PV alarm group and PV non alarm group(P<0.05).There were no significant differences in age,gender,BMI,INR,FIB,APTT and femoral vein catheterization time between PV alarm group and PV non alarm group(P>0.05).Conclusion When the patients of liver failure were treated with DPMAS combined with PE,and PA alarm was more likely to occur within the first 30 minutes,while PBE alarm was more likely to occur about 1 hour after the treatment.PV alarm was related to platelet count and Pt,PTA of coagulation function.
作者
潘金良
任洁雅
鲁晓擘
邓泽润
唐莉
姚磊
郑嵘炅
PAN Jinliang;REN Jieya;LU Xiaobo;DENG Zerun;TANG Li;YAO Lei;ZHENG Rongjiong(Center of Infectious Disease,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《新疆医科大学学报》
CAS
2021年第12期1323-1326,共4页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区自然科学基金(2020D01C243)。
关键词
双重血浆分子吸附
血浆置换
报警
影响因素
plasma exchange
double plasma molecular adsorption
alarm
influence factor
