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- W3030252077 abstract "本研究为单中心、回顾性队列研究，通过纳入2012年7月至2018年3月在海南医学院第一附属医院肾内科住院行腹膜透析置管术的慢性肾脏病（CKD）5期患者79例，按置管术后出血与否，分为出血组（8例）和未出血组（71例），对两组患者的临床基本资料及术前、术后7 d内凝血系统相关数据（血红蛋白、血小板、凝血功能）进行分析，旨在探讨及分析CKD 5期患者腹膜透析置管术后出血的相关因素。结果发现，两组患者年龄、性别、病因以及术前尿素氮、血白蛋白、血小板计数、分布宽度及比容的差异均无统计学意义（均P>0.05）。同时，术前出血组总血钙、血红蛋白、肾小球滤过率低于未出血组，血肌酐及血小板体积高于未出血组，且术前及术后的凝血酶原时间（PT）、国际标准化比值（INR）较未出血组延长，术后纤维蛋白原（Fbg）、抗凝血酶III（AT-III）下降，D-二聚体及纤维蛋白原降解产物（FDP）增高（均P<0.05）。针对手术前后凝血指标进行配对t检验结果显示，手术可导致患者凝血功能发生异常，手术前后两组患者的FDP、D-二聚体的差异有统计学意义（P<0.05），术后两者均较前升高。二元Logistic回归分析显示，血钙、AT-III是影响出血的保护因素，而肌酐是独立危险因素。作者认为，通常情况下大多数腹膜透析置管术后出血患者不需要二次手术，出血持续时间短，术后发生纤溶亢进较少，经止血、局部处理及积极抗纤溶可治愈。针对腹膜透析置管术后出血致纤溶亢进情况，在术前充分评估、术后严密观察的基础上，对于术前总血钙低、血肌酐高、AT-III低且CKD分期高的患者，应预防术后继发性纤溶亢进发生；若发生，治疗及时得当可使病情及早得到控制。" @default.
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- W3030252077 date "2019-01-15" @default.
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- W3030252077 title "Analysis of the causes of hemorrhage after peritoneal dialysis in 5 stage patients with single center chronic kidney disease" @default.
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