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血液透析是急、慢性肾功能衰竭与减经急性中毒的主要治疗手段,但透析膜上纤维蛋白—血小板栓的形成大大降低其治疗疗效,且可导致栓塞形成,产生严重併发症。其次,在透析膜上通常有中性粒细胞粘附和补体激活,后者通过C_3a和C_5a能释放致白细胞栓塞形成,使临床问题更为复杂。目前血栓栓塞症仍是血透时主要的临床问题,故需局部或全身肝素化。局部肝素化即在血液离开病人的动脉管道内加入肝素,而在血回流到病人的静脉管道内用鱼精蛋白中和。血小板抑制药物可降低血小板在透析膜上粘附,但因尿毒症患者往往已有血小板功能损害,故应用抗血小板药须非常谨慎。
Hemodialysis is the main treatment of acute and chronic renal failure and acute poisoning after hypnotherapy. However, the formation of fibrin-thrombocyte in dialysis membrane greatly reduces its curative effect and leads to the formation of embolism with serious complications. Second, there is usually neutrophil adhesion and complement activation on the dialysis membrane, which can lead to the formation of leukocyte embolization through the release of C_3a and C_5a, making the clinical problems more complicated. Thromboembolism is still the main clinical problems when hemodialysis, it is required local or systemic heparinization. Local heparinization involves the addition of heparin to the arterial line from which the blood leaves the patient, and is neutralized with protamine in the venous conduit where blood returns to the patient. Platelet inhibitors can reduce the adhesion of platelets on the dialysis membrane, but patients with uremia often have impaired platelet function, so the use of antiplatelet drugs must be very cautious.