摘要
目的探讨两段式柠檬酸抗凝治疗在活动性出血或高危出血风险的血液透析患者中的应用效果。方法选择2021年5月至2022年3月广西壮族自治区柳州市工人医院收治的100例活动性出血或高危出血风险的血液透析患者为研究对象,根据随机数字表法将其分为研究组及对照组,各50例。对照组透析中采用一段式柠檬酸抗凝治疗,研究组透析中采用两段式柠檬酸抗凝治疗。比较两组的透析时间、透析器抗凝有效率、静脉壶抗凝有效率,比较两组透析血气指标和外周血清电解质水平及透析结束时血液透析尿素清除情况。记录两组不良事件的发生情况。结果研究组透析时间长于对照组,静脉壶抗凝有效率高于对照组,差异有统计学意义(P<0.05)。透析后,两组血pH值、HCO_(3)^(-)高于治疗前,差异有统计学意义(P<0.05)。研究组在线Kt/V值高于对照组,差异有统计学意义(P<0.05)。透析期间,两组不良事件总发生率比较,差异无统计学意义(P>0.05)。结论对活动性出血或高危出血风险的血液透析患者,两段式柠檬酸抗凝治疗在透析时间、静脉壶抗凝有效率方面优于一段式柠檬酸抗凝治疗,尿素清除方面也更具优势。
Objective To investigate the application effect of two-stage citric acid anticoagulant therapy in hemodialysis patients with active bleeding or high risk of bleeding.Methods A total of 100 hemodialysis patients with active bleeding or high risk of bleeding admitted to Liuzhou Worker’s Hospital,Guangxi Zhuang Autonomous Region from May 2021 to March 2022 were selected as the study objects,and they were divided into study group and control group according to random number table method,with 50 cases in each group.The control group was treated with one-stage citric acid anticoagulant therapy,while the study group was treated with two-stage citric acid anticoagulant therapy.The dialysis time,anticoagulant efficiency of dialyzer,anticoagulant efficiency of intravenous pot of the two groups were compared,and the hemodialysis blood gas index,peripheral blood serum electrolyte level,and urea clearance at the end of dialysis were compared between the two groups.The occurrence of adverse events in both groups was recorded.Results The dialysis time of the study group was longer than that of the control group,and the anticoagulant effect of intravenous pot was higher than that of the control group,the differences were statistically significant(P<0.05).After dialysis,the blood pH value and HCO_(3)^(-) of the two groups were higher than those before treatment,and the differences were statistically significant(P<0.05).The online Kt/V value of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).During dialysis,there was no significant difference in the total incidence of adverse events between the two groups(P>0.05).Conclusion For hemodialysis patients with active bleeding or high risk of bleeding,two-stage citric acid anticoagulant therapy is superior to one-stage citric acid anticoagulant therapy in terms of dialysis time,anticoagulant efficiency of intravenous pot,and urea clearance in hemodialysis.
作者
吴春香
刘春晓
张崔勇
罗舒文
韦新月
罗春明
WU Chunxiang;LIU Chunxiao;ZHANG Cuiyong;LUO Shuwen;WEI Xinyue;LUO Chunming(Department of Nephrology,Liuzhou Worker’s Hospital,Guangxi Zhuang Autonomous Region,Liuzhou545000,China)
出处
《中国医药导报》
2023年第34期120-123,共4页
China Medical Herald
基金
广西壮族自治区卫生厅自筹经费科研课题(Z20211195)。
关键词
血液透析
柠檬酸
分段抗凝
应用效果
Hemodialysis
Citric acid
Segmentation of anticoagulant
Application effect
