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Chinese Journal of Blood Purification ›› 2004, Vol. 3 ›› Issue (9) : 493-495.

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Abstract

Objective To obtain an optimal therapeutic dosage of heparin in gravis hepatitis patients with the treatment of artificial liver. Methods Comparing the change of APTT between gravis hepatitis patients and dialysis patients, and that in gravis hepatitis patients using different dosage of heparin. Real time Monitoring of APTT was adopted to adjust the dosage of heparin. Blood clots in the pipeline and bleeding in the skin and punctured site were observed. Results The change of APTT after applying heparin was much greater in gravis hepatitis patients than that in dialysis patients. Blood clots in the pipeline were found in two patients in low-dosage heparin group without interfering the treatment. One patient had bleeding in the puncture site in the high-dosage heparin group. Five minutes and 30 minutes after applying heparin in the high-dosage heparin group, the ratio of prolonged APTT above 100s was 90.5% and 47.6% respectively, and higher than that in the low-dosage heparin group. Neither coagulation nor bleeding was occurred in the condition which APTT was prolonged up to 40%～80% compared with the normal value. Conclusion The change of coagulation function after applying heparin is more obvious in gravis hepatitis patients. The required dosage of heparin for anti-coagulation is relatively less in gravis hepatitis patients compared with dialysis patients. APTT is prolonged up to 40%-80% compared with the normal value which can not only prevent coagulation in the pipeline but also decrease the risk of bleeding.