中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (02): 173-176.doi: 10.3969/j.issn.1671-4091.2026.02.019

• 护理研究 • 上一篇    

闭式动态循环肝素法预冲灌流器在血液灌流联合血液透析治疗中的应用

赵东建   赵 慧   丁嘉祥   王 梅   罗 莉   

  1. 102206 北京，1北京大学国际医院肾内科
    100044 北京，2北京大学人民医院肾内科

  • 收稿日期:2025-10-30 修回日期:2025-12-04 出版日期:2026-02-12 发布日期:2026-02-02
  • 通讯作者: 罗莉 E-mail:luoli@Pkuih.edu.cn
  • 基金资助:

Application of closed dynamic circulating heparin method for prefilling hemoperfusion cartridge in hemoperfusion combined with hemodialysis therapy

ZHAO Dong- jian, ZHAO Hui, DING Jia- xiang, WANG Mei , LUO Li   

  1. Department of Nephrology, Peking University International Hospital, Beijing 102206, China; 2Department of Nephrology, Peking University People ’s Hospital, Beijing 100044, China
  • Received:2025-10-30 Revised:2025-12-04 Online:2026-02-12 Published:2026-02-02
  • Contact: 102206 北京，1北京大学国际医院肾内科 E-mail:luoli@Pkuih.edu.cn
  • Supported by:

摘要： 目的 血液透析联合血液灌流是目前临床经常采用的治疗模式，而灌流器凝血是治疗中易发生的现象。闭式静态肝素法预冲灌流器是普遍采用的方法。本研究探讨了闭式动态循环肝素法预冲灌流器的可行性，并与闭式静态肝素法预冲灌流器方法相比，观察对灌流器凝血的影响。 方法 选取在北京大学国际医院透析室进行维持性血液透析治疗的32例患者, 每周透析3次，其中血液透析联合血液灌流1次。采用自身前后对照，每位患者行血液灌流联合血液透析时先后使用闭式动态循环肝素法8次和闭 式 静 态 肝 素 法 8 次。记 录 每 次 行 血 液 透 析 加 血 液 灌 流 时 肝 素 的 用 量，并 对 灌 流 器 凝 血 情 况 进 行 评估。 结果 闭 式 动 态 循 环 肝 素 法 治 疗 过 程 肝 素 用 量 与 闭 式 静 态 肝 素 法 无 统 计 学 差 异(t=-1.730，P=0.094)；闭式动态循环肝素法预冲灌流器凝血发生率低于闭式静态肝素法(χ2=11.633，P=0.009)，其中闭式动态循环肝素法预冲灌流器2级凝血发生率(χ2=4.552，P=0.033)、3级凝血发生率(χ2=4.129，P=0.042)低于闭式静态肝素法。 结论 在肝素使用量无差异的情况下，闭式动态循环肝素法预冲灌流器在血液灌流联合血液透析治疗预防灌流器凝血方面优于闭式静态肝素法，可以在临床中推广使用。

关键词: 闭式动态循环肝素法；闭式静态肝素法；灌流器凝血, 血液透析

Abstract: Objective Hemodialysis combined with hemoperfusion is a commonly adopted clinical treatment mode, and hemoperfusion cartridge coagulation occurs frequently during treatment. Closed static heparin priming of hemoperfusion cartridge is a widely used method. This study aimed to explore the feasibility of closed dynamic circulation heparin priming for hemoperfusion cartridge and to observe its effect on cartridge coagulation, as compared those with closed static heparin priming. Methods A total of 32 patients undergoing maintenance hemodialysis in the Dialysis Unit of Peking University International Hospital were enrolled. They received hemodialysis 3 times a week, including 1 session of hemodialysis combined with hemoperfusion. A self-controlled before-and-after design was adopted. Every patient underwent 8 sessions of hemodialysis combined with hemoperfusion using closed dynamic circulation heparin priming and 8 sessions using closed static heparin priming. The heparin dosage was recorded for each session of hemodialysis combined with hemoperfusion, and the coagulation status of the hemoperfusion cartridge was evaluated. Results There was no significant difference in heparin dosage during treatment between closed dynamic circulation heparin method and closed static heparin method (58.41±7.23mg vs. 59.24±6.96mg, t=-1.730, P=0.094). The incidence of hemofilter coagulation during priming in closed dynamic circulation heparin method was lower than that in closed static heparin method (χ²=11.633, P=0.009). Specifically, the incidence of grade 2 hemofilter coagulation during priming in closed dynamic circulation heparin method was significantly lower than that in closed static heparin method (χ²=4.552, P=0.033), and the incidence of grade 3 hemofilter coagulation was also significantly lower in closed dynamic circulation heparin method (χ²=4.129, P=0.042). Conclusion In the absence of a difference in heparin dosage, closed dynamic circulation heparin priming for hemoperfusion cartridges is superior to closed static heparin priming in preventing hemoperfusion cartridge coagulation during hemodialysis combined with hemoperfusion. It is worthy of clinical promotion and application.

Key words: Closed dynamic circulating heparin method, Closed static heparin method, Hemoperfusion cartridge coagulation, Hemodialysis

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