摘要
目的探讨低分子肝素和局部枸橼酸抗凝方案对危重症患者连续性肾脏替代治疗的临床效果差异。方法选取2020年1月至2021年12月于扬州大学医学院附属沭阳医院肾病科接受连续性肾脏替代治疗的76例危重症患者作为研究对象,根据不同抗凝技术分为枸橼酸钠组(38例)和低分子肝素组(38例)。比较两组患者一般临床指标、凝血功能指标、血细胞及炎症因子水平及并发症发生情况。结果枸橼酸钠组超滤量和滤器寿命高于低分子肝素组,枸橼酸钠组重症监护时间和住院时间短于低分子肝素组,差异有统计学意义(P<0.05)。治疗前,两组患者各项凝血功能指标比较,差异无统计学意义(P>0.05);治疗后,枸橼酸钠组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)和凝血酶时间(TT)均低于低分子肝素组,差异有统计学意义(P<0.05);枸橼酸钠组纤维蛋白原(FIB)高于低分子肝素组,差异有统计学意义(P<0.05)。治疗前两组患者血细胞及炎症因子水平比较,差异无统计学意义(P>0.05);治疗后,枸橼酸钠组各项血细胞及炎症因子水平均低于低分子肝素组,差异有统计学意义(P<0.05)。枸橼酸钠组并发症总发生率显著低于低分子肝素组,差异有统计学意义(P<0.05)。结论在危重症患者连续性肾脏替代治疗中采用局部枸橼酸钠抗凝方案对凝血功能影响较小,可有效降低炎症水平,延长滤器使用寿命,安全性较好。
Objective To explore the differences in clinical efficacy between low molecular weight heparin and local citrate anticoagulation treatment for continuous renal replacement therapy in critically ill patients.Methods A total of 76 critically ill patients who underwent continuous renal replacement therapy at the Nephrology Department of Shuyang Hospital Affiliated to the Medical College of Yangzhou University from January 2020 to December 2021 were selected as the subjects.According to different anticoagulation techniques,they were divided into sodium citrate group(38 cases)and low molecular weight heparin group(38 cases).The general clinical indicators,coagulation function indicators,blood cell and inflammatory factor levels,and incidence of complications of patients between two groups were compared.Results The ultrafiltration volume and filter life of the sodium citrate group were higher than those of the low molecular weight heparin group,and the intensive care time and hospitalization time of this group were shorter than those of the low molecular weight heparin group,with statistically significant differences(P<0.05).There was no statistically significant difference in various coagulation function indicators before treatment between the two groups(P>0.05).The activated partial thromboplastin time(APTT),prothrombin time(PT),and thrombin time(TT)after treatment of the sodium citrate group were lower than those of the low molecular weight heparin group,with statistically significant differences(P<0.05);The fibrinogen(FIB)levels after treatment in the sodium citrate group were significantly higher than those in the low molecular weight heparin group,with statistically significant difference(P<0.05).There were no statistically significant differences in the levels of blood cells and inflammatory factors before treatment between the two groups(P>0.05).The levels of various blood cells and inflammatory factors after treatment in the sodium citrate group were lower than those in the low molecular weight heparin group,w
作者
王嫚
WANG Man(Nephrology Department,Shuyang Hospital Affiliated to Medical College of Yangzhou University,Jiangsu,Shuyang 223600,China)
出处
《中国医药科学》
2023年第22期175-178,190,共5页
China Medicine And Pharmacy
关键词
危重症
低分子肝素
局部枸橼酸抗凝
连续性肾脏替代治疗
Critical illness
Low molecular weight heparin
Regional citrate anticoagulation
Continuous renal replacement therapy
