抄録
The high bleeding risk patients should be strictly restricted the prolongation clotting time during and after homodialysis.
We investigated the precise heparin neutralization rate with the monitoring of WBAPTT in vivo examination.
Minimal heparinization (M·H) and Regional heparinization (R·H) were also evaluated clinically in the high bleeding risk patients during hemodialysis.
1) One mg of protamine could be neutralized 95.4 u. of heparin in vivo examination, and 1.1mg of protamine neutralized 99.4 u. of heparin, There were significant differences of heparine neutralization rates between 1mg and 1.1mg of protamine.
2) In the one shot of protamine at the end of dialysis, average heparine neutralization was 106.7% by the theoretical doseges of protamine caluculate from WBAPTT (average doses: 5.6mg) and 109.0% by the conventional doses of 30mg of protamine.
3) We could reducted the total heparin doses. to 46% by the usage of M·H compared with optimal heparinization.
4) The heparin rebound phenomenon were not noticed definitely in 8 patients by the R·H (protamine heparine rate: 1.36).
We concluded that M·H and R·H are safe in the dialysis for high bleeding risk patients than the conventional method and the clotting time in the extra coporeal circulation can be controlled easier by the M·H than R·H.
