中国血液净化 ›› 2018, Vol. 17 ›› Issue (02): 133-136.doi: 10.3969/j.issn.1671-4091.2018.02.014

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血液透析中管路折曲引发的溶血及其防治

高爽1   

  1. 1. 中国人民解放军第309医院旃坛寺门诊部
  • 收稿日期:2017-10-27 修回日期:2017-08-28 出版日期:2018-02-12 发布日期:2018-02-12

Acute Hemolysis induced by kinked blood line during hemodialysis and its prevention and management

  • Received:2017-10-27 Revised:2017-08-28 Online:2018-02-12 Published:2018-02-12

摘要: 血液透析中因管路折曲引发的急性溶血是威胁患者生命的并发症之一。尽管血液透析期间管路折曲的溶血发生率很低,但其危害极其严重,如果未能及时发现并采取有效措施,可能引发高血钾症,急性胰腺炎等并发症,甚至引起死亡,因而它是一个不容忽视的透析安全问题。本文在回顾国外对这方面报道的基础上,着重分析讨论管路折曲引起的溶血的原因、诊断、预防与处理问题,旨在引起从事血液透析的医护人员对管路折曲引起的溶血的高度重视,避免血液透析中溶血的发生,保证患者透析安全与最佳透析效果。

关键词: 血液透析, 管路折曲, 机械性溶血, 血液回路压力, 不良事件

Abstract: Acute hemolysis induced by linked blood line during hemodialysis is one of the life-threatening complications. The occurrence rate is rare. However, if the kinked blood line cannot be detected and resolved promptly, the outcome is severe due to the complications including hyperkalemia, acute pancreatitis and even death following acute hemolysis. This paper focuses on the mechanism, diagnosis, prevention and management of acute hemolysis based on review of the literature about hemolysis events, in order to strengthen the recognition and the aware of hemolysis risk induced by kinked blood line in dialysis staffs, to protect the patients from hemolysis events, and to ensure safety and optimal efficiency for hemodialysis patients.

Key words: Hemodialysis, kinked of blood line, Mechanical hemolysis, pressure in blood circuit , Adverse event