局部枸橼酸抗凝在高危出血倾向患者血液透析中的应用  

Clinical Application of Regional Citrate Anticoagulation in Hemodialysis in the Patients with Increased Risk of Bleeding

作　　者：鄢建军[1] 耿哲[1] 杜翔[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院血液净化中心,湖北武汉430030

出　　处：《护理学杂志》2005年第7期17-19,共3页

摘　　要：目的探讨局部应用枸橼酸抗凝法行血液透析(HD)治疗的临床应用价值。方法采用自身对照法将46 例具有高危出血倾向的HD患者按治疗单、双日分为观察组、对照组。观察组采用局部枸橼酸体外抗凝法HD治疗57例次,对照组采用传统的无肝素生理盐水冲洗法HD治疗40 例次,比较两组患者的出血情况、透析器和静脉壶的凝血情况、治疗时间和超滤量以及透析前后的各项生化指标。结果两组无1 例诱发或加重出血,观察组的透析器和静脉壶的凝血情况、治疗时间和超滤量以及透析前后血生化指标差值明显优于对照组(均P<0.05)。结论局部枸橼酸抗凝应用于高危出血倾向血液透析患者安全有效。Objective To evaluate the clinical value of regional citrate anticoagulation (RCA) to hemodialysis (HD) for patients with increased risk of bleeding. Methods Ninety-seven sessions hemodialysis of the 46 patients with increased risk of bleeding were randomly divided two groups. In the experiment group (even day), 57 sessions were treated with regional citrate anticoagulation, while 40 sessions in control group (odd day) with traditional rinse normal saline without heparinization. The efficiency of extracorporeal coagulation, treatment time, ultrafiltration value, serum creatinine and urea concentration in the two groups were compared. Results The efficiency of extracorporeal coagulation, treatment time, ultrafiltration value, serum creatinine and urea concentration in the experiment group were significantly better than in control group (all P<0.05). Conclusion Regional citrate anticoagulation is a safe and effective method for patients with increased risk of bleeding.

关 键 词：肾衰竭 枸橼酸 抗凝 血液透析 高危出血倾向 

分 类 号：R473.5[医药卫生—护理学] R973.2[医药卫生—临床医学]