关键词: 人工肝, 动脉管路血, 外周静脉血, 凝血指标

Abstract: Objective To analyze whether there are differences in coagulation indexes between arterial end-line blood and peripheral venous blood during artificial liver treatment.Methods Twenty patients with liver disease treated by dual plasma molecular sorption (DPMAS) in our hospital from March 2018 to August 2018 were selected. With fixed-dose heparin as anticoagulant, blood samples from arterial end pipeline and peripheral venous blood were collected simultaneously for the detection of coagulation indicators, and the differences of coagulation indicators between the 2 sites were compared.Results There was no significant difference in the coagulation indicators between arterial end-line blood and peripheral venous blood in the course of DPMAS treatment in 20 patients (P>0.05). The activated partial thromboplastin time (APTT) of peripheral venous blood was (103.6 + 44.7) s, which was consistent with that of arterial end-line blood (105.2 + 54.2) s (P>0.05). APTT was > 400s (non-agglutinated state) in 30% of peripheral venous blood and 25% of arterial end-line blood. The consistency test of the 2 groups showed that the kappa coefficient was 0.875 (P=0.000), and the non-agglutinated rate of the 2 groups was consistent. All of the 20 cases received DPMAS treatment successfully, 1 patient experienced bleeding at the puncture site, and 4 patients were injected with more heparin due to increased transmembrane pressure.Conclusion During the artificial liver treatment, the coagulation indexes of arterial end-line blood can be used to represent that of peripheral venous blood in the study of heparin anticoagulation. The heparin regimen in this study needs further evaluation and adjustment.

Key words: Artificial liver treatment, Arterial line blood, Peripheral venous blood, Coagulation index