局部枸橼酸体外抗凝在高危出血风险患者持续肾脏替代治疗中的运用价值.pdfVIP

CHINESECOMMUNITY DOCTORS 论著·临床论坛 局部枸橼酸体外抗凝在高危出血风险患者 持续肾脏替代治疗中的运用价值 李德勇 212400江苏省句容市人民医院 doi:10.3969/j.issn.1007-614x.2016.22.63 摘 要 目的：探讨局部枸橼酸体外抗凝(RCA)在高危出血风险患者持续肾脏替代治疗中的运用价值。方法：收治高 危出血风险患者52例，随机分为对照组和观察组，对照组行低分子肝素抗凝，观察组行RCA，比较两组抗凝效果。 结果：两组治疗前后Ca和HB指标差异无统计学意义(P＞0.05)；观察组治疗前和治疗后pH值和外周血离子钙差异无 统计学意义(P＞0.05)，滤器后离子钙和治疗前对比显著降低(P＜0.05)；观察组滤器平均寿命显著高于对照组，且出血 发生率显著低于对照组(P＜0.05)。结论：局部枸橼酸体外抗凝(RCA)在高危出血风险患者持续肾脏替代治疗中的运用 价值显著。 关键词 局部枸橼酸体外抗凝；高危出血风险；运用价值 Usevalueofregionalcitrateanticoagulationinrenalreplacementtherapyforpatientswithhigh-riskbleedingrisk LiDeyong ThePeoplesHospitalofJurongCity,JiangsuProvince212400 Abstract Objective:Toexploretheusevalueofregionalcitrateanticoagulation(RCA)inrenalreplacementtherapyforpatients withhigh-riskbleedingrisk.Methods:52patientswithhigh-riskbleedingriskwereselected.Theywererandomlydividedintothe control group and the observation group.The control group was given low molecular weight heparin anticoagulation.The observationgroupwasgivenRCA.Wecomparedtheanticoagulationeffectofthetwogroups.Results:Therewasnosignificant differenceinCaandHBbetweengroupsbeforeandaftertreatment(P＞0.05).Intheobservationgroup,therewasnosignificant differenceinthepHvalueandtheperipheralbloodcalciumbeforeandaftertreatment(P＞0.05).Afterthefilter,comparedwith beforetreatment,thecalciumionwassignificantlyreduced(P＜0.05).Intheobservationgroup,theaveragelifeexpectancyofthe filterwassignificantlyhigherthanthatofthecontrolgroup,andtheincidenceofbleedingwassignificantlylowerthanthatofthe control group(P＜0.05).Conclusion:The use value of regional citrate anticoagulation(RCA) in renal replacement therapy for patientswithhigh-riskbleedingriskwassignificant. Keywords Regionalcitrateanticoagulation;High-riskbleedingrisk;Usevalue 持续肾脏替代治疗因为溶质消除较