关键词: 多脏器功能不全综合征, 连续性静脉静脉血液滤过, 高出血风险, 凝血功能, 有效性, 安全性

Abstract: [Abstract] Objective To investigate safety and efficiency of anti- coagulation methods in the patients with high-risk bleeding multiple organ dysfunction syndrome (MODS) during continuous veno-venous hemofiltration(CVVH). Methods Forty patients with high-risk bleeding MODS during CVVH in our hospital were divided into heparin-free group(A group) and low-dose heparin group(B group). The changes of blood coagulation function, the counts of platelets, blood urea nitrogen, serum creatinine, PaO2/FIO2 and Apache Ⅱscores in two groups before treatment, at 24h,48h after treatment were measured. Filter lifespan, median ventilation time, ICU admission time and bleeding complications were observed. Results 1. There was significant difference between the levels of blood urea nitrogen, serum creatinine, PaO2/FIO2 and Apache Ⅱscores at 24h,48h after treatment in low-dose heparin group and that in heparin-free group (P<0.05).2. The levels of APTT, TT were prolonged,the counts of PLT were significantly lower at 24h after treatment than that before treatment in low-dose heparin group, the levels of APTT, TT, the counts of PLT had no changes comparing prolonged time of CVVH therapy. 3. Average ventilation time, ICU admission time were obviously shorter in low-dose heparin group than that in heparin-free group, Filter lifespan was longer in low-dose heparin group than that in heparin-free group, there was significant difference (P<0.05). 4. Bleeding in skin and mucosa was observed in 1 case in low-dose heparin group, there was no other severe bleeding complications. Conclusion The results of monocentic study show that low dose of heparin ensure smooth operation of CVVH in the Patients with MODS with high-risk bleeding, clinical application is safe, efficient.

Key words: Multiple organ dysfunction syndrome, Continuous Veno- Venous Hemofiltration, High-risk bleeding, coagulation function, Efficiency, Safety