ABSTRACT
Objective To observe the impact of three different concentration heparin tube -sealing solution on the jugular vein integrated catheter in hemodialysis(HD)patients.Methods 96 HD patients were selected and divided into three groups according to different treatments.Each group had 32 cases.Patients in A,B and C group received heparin sodium 30mg,40mg,60mg respectively.The degree of symptoms improvement and the complications in the three groups were evaluated.Results For bleeding,catheter position adverse,arrhythmia,air embolism, A group had 10 cases,11 cases,8 cases,5 cases;B group had 9 cases,8 cases,9 cases,4 cases;C group had 2 cases, 1 case,1 case,0 case.Compared with B group and A group,C group had lower complication,the difference was statis-tically significant(χ2 =6.667,10.42,4.706 and 5.450,4.706,7.680,all P 0.05);For the infection and throm-bosis,A group had 10 cases,8 cases;B group had 9 cases,8 cases;C group had 1 case,1 case.Compared with B group and A group,C group had lower complication,the difference was statistically significant (χ2 =7.680,4.706,all P 0.05 ). Conclusion Treatment with 60mg heparin saline solution for HD patients will help to improve symptoms in patients, and decrease complications,thus it is worth for further promotion in clinical practice.
ABSTRACT
Objective To evaluate the effectiveness of professional nurses in atrial fibrillation (AF) anticoagulation management system.Methods 217 consecutive patients with nonvalvular AF were enrolled.All patients received warfarin therapy for 3-6 months after catheter ablation for AF,who were divided into experimental group (n=102) and control group (n=115) by random digits table.The patients of control group adjusted their warfarin doses by following doctor's advice when discharged and by visiting the outpatient clinic regularly after discharged.The patients of treatment group adjusted their warfarin doses under the guidance of one well-trained nurse.Days of the international normalized ratio (INR) value achieved therapeutic anticoagulation range (2.0-3.0) for the first time,the effective anticoagulation rate that defined as more than 70％ of INR values between 2.0-3.0 after titration period,the ratio of times of INR value 2.0-3.0 to total times after titrating and INR monitoring frequency were compared between the 2 groups.Results In treatment group,days of the INR value achieved therapeutic 2.0-3.0 for the first time were less than that in control group (8 d vs.15 d,P＜0.01),the effective anticoagulation rate [45.1％(46/102)] and the ratio of times of INR value 2.0-3.0 to total times after titrating (67.6％±18.5％) was significantly higher than that in control group [31.3％(36/115) and 62.0％±23.1％ respectively,P＜0.05].INR monitoring during the whole period and after titrating were more frequently in treatment group [(9.4±2.2)times vs.(8.4±2.7) times,P＜0.05;(7.9±2.4) times vs.(6.3±2.8) times,P＜0.01].The number of patients in treatment group who monitor INR less than 3 times after titrating was larger than that in control group (18 vs.1,P＜0.01).Conclusions The participation of professional nurses in atrial fibrillation anticoagulation management system was helpful not only in achieving INR 2.0-3.0 more quickly but also in improving the effective anticoagulation rate.