摘要
目的:研究并比较枸橼酸抗凝与无抗凝血液滤过治疗肾衰竭合并脑出血患者的临床效果。方法:选取2016年6月—2017年3月60例肾衰竭合并脑出血患者,采取计算机单盲分组法随机分为两组,对照组30例患者接受无抗凝血液滤过治疗,观察组30例患者接受枸橼酸抗凝血液滤过治疗,比较两组患者肾功能指标、滤器寿命、凝血功能指标、血常规指标以及病死率。结果:观察组治疗后的血清肌酐、尿素氮均明显低于治疗前(P<0.05),且低于对照组治疗后(P<0.05);观察组的滤器寿命明显长于对照组(P<0.05);观察组治疗后的活化部分凝血酶时间(APTT)、血浆凝血酶时间(TT)、血红蛋白(Hb)、血小板(PLT)与治疗前比较均无明显变化(P>0.05),而对照组治疗后的Hb、PLT与治疗前比较,变化明显(P<0.05);观察组10d内病死率略低于对照组,但差异无统计学意义(P>0.05)。结论:在肾衰竭合并脑出血患者的血液滤过治疗中,采用枸橼酸抗凝可延长滤器寿命,有效减少血液滤过不良反应,提高治疗效果,有利于改善肾功能。
Objective： To study and compare the clinical effect of citrate anticoagulation and anticoagulant filtration therapy in patients with renal failure complicated with cerebral hemorrhage. Methods： A total of 60 patients with renal failure complicated with cerebral hemorrhage were selected from June 2016 to March 2017. The patients were randomly divided into two groups： the control group（ n = 30） received 30 patients with no anticoagulation after treatment,30 patients in the observation group received citrate anticoagulant hemofiltration therapy,the renal function,filter life,coagulation function,blood routine index and mortality were compared between the two groups. Results： Serum creatinine and urea nitrogen in the observation group were significantly lower than those in the control group（P〈0. 05）,and it was lower than that in the control group（P〈0. 05）.The filter life of the observation group was significantly longer than that of the control group（P〈0. 05）. The activated partialthromboplastin time（ APTT）,thrombin time（ TT）,hemoglobin（ Hgb） and platelet（ PLT） of the observation group after treatment which compared with before treatment had no significant change（P〈0. 05）,while the Hgb and PLT of the control group after treatment which compared with before treatment had significantly changed（P〈0. 05）. In the control group,but the difference was not statistically significant（P〈0. 05）. Conclusion： In the treatment of patients with renal failure combined with cerebral hemorrhage,the use of citrate anticoagulation can prolong the life of the filter,effectively reduce the adverse effects of blood filtration,improve the therapeutic effect,and improve the renal function.
出处
《临床医药实践》
2017年第10期725-727,共3页
Proceeding of Clinical Medicine
基金
江西省卫生计生委科技计划项目(项目编号:2017722)
关键词
肾衰竭
脑出血
血液滤过
枸橼酸抗凝
无抗凝
renal failure
cerebral hemorrhage
hemofiltration
citrate anticoagulation
no anticoagulation
