摘要
目的观察局部枸橼酸抗凝在连续性肾替代疗法(CRRT)治疗中的应用效果。方法入选需进行CRRT治疗的危重症患者183例,分为对照组(n=90)及试验组(n=93)。对照组患者给予低分子肝素抗凝,试验组给予局部枸橼酸抗凝。比较2组患者血常规指标、凝血功能指标及肾功能指标、安全性指标的变化。结果治疗后,对照组与试验组白细胞计数(WBC)分别为(12.14±1.25)×10^9/L,(11.97±1.46)×10^9/L,血尿素氮(BUN)含量分别为(13.47±2.35),(10.02±2.12)mmol·L^-1,血肌酸酐(Scr)含量分别为(298.79±30.15),(212.37±29.14)μmol·L^-1,肌酸酐清除率(Ccr)分别为(31.46±7.23),(39.25±7.11)mL·min^-1,出血率分别为17.78%,1.08%,滤器凝血发生率分别为31.11%,10.75%,差异均有统计学意义(均P<0.05)。2组血小板计数(PLT)、凝血酶原时间(PT)、活化部分凝血酶时间(APTT)及iCa^2+、K^+、HCO3^-含量差异均无统计学意义(均P>0.05)。结论局部枸橼酸抗凝对CRRT抗凝效果显著,可有效延长滤器使用寿命,改善患者肾功能,且不会影响患者凝血功能。
Objective To explore the application effect of regional citrate anticoagulation in continuous renal replacement therapy(CRRT).Methods A total of 183 cases severe patients required CRRT were divided into control group(n=90)and treatment group(n=93).Patients in control group were treated with low molecular heparin anticoagulation,patients in treatment group were treated with regional citrate anticoagulation.The routine blood,blood coagulation function,renal function and safety indicators changes of patients in two groups were compared.Results After treatment,the white blood cell count(WBC)in control group and treatment group were(12.14±1.25)×10^9/L,(11.97±1.46)×10^9/L,the blood urea nitrogen(BUN)were(13.47±2.35),(10.02±2.12)mmol·L^-1,serum creatinine(Scr)were(298.79±30.15),(212.37±29.14)μmol·L^-1,creatinine clearance rate(Ccr)were(31.46±7.23),(39.25±7.11)mL·min^-1,incidence of bleeding were 17.78%,1.08%,incidence of filter blood coagulation were 31.11%,10.75%,all with significant difference(all P<0.05).The platelet count(PLT),prothrombin time(PT),activated partial thrombin time(APTT)and i Ca^2+,K^+,HCO3^-in two groups were with no significant difference(P>0.05).Conclusion The anticoagulant effect of regional citrate anticoagulation for patients with CRRT is remarkable,which can prolong the service life of the filter,improve the renal function of patients,and does not affect the coagulation function of patients.
作者
卜春红
陈琳光
郑国利
BU Chun-hong;CHEN Lin-guang;ZHENG Guo-li(Department of Critical Medicine,Chengde Medical College Affiliated Hospital,Chengde 067000,Hebei Province,China;Department of Hepatobiliary Surgery,Chengde Medical College Affiliated Hospital,Chengde 067000,Hebei Province,China;Department of Radiology,Chengde Medical College Affiliated Hospital,Chengde 067000,Hebei Province,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2020年第6期602-605,共4页
The Chinese Journal of Clinical Pharmacology
关键词
连续性肾替代疗法
枸橼酸
低分子肝素
凝血功能
肾功能
continuous renal replacement therapy
citrate
low molecular heparin
blood coagulation function
renal function
