枸橼酸钠抗凝在中高危出血患者血液净化治疗中的临床评价  

Clinical evaluation of natrium citricum anticoagulation in the treatment of blood purification in patients with middle- and high-risk hemorrhage

作　　者：刘清林 王迎莉[1] 王志方[1] LIU Qing-lin;WANG Ying-li;WANG Zhi-fang(Zhongshan Hospital Affiliated to Dalian University,Dalian 116001,China)

机构地区：[1]大连大学附属中山医院

出　　处：《实用药物与临床》2019年第10期1051-1054,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的评价局部枸橼酸钠抗凝在中高危出血患者连续性血液净化(CBP)治疗中的价值。方法选取2013年2月至2018年2月我院ICU与肾内科需行CBP治疗的中高危出血患者54例,随机分为2组:观察组26例,对照组28例。对照组采用无抗凝技术;观察组采用局部枸橼酸钠抗凝技术。观察两组患者治疗前后血肌酐(Scr)及尿素氮(BUN)水平、凝血酶原时间(PT)、活化部分凝血活酶时间(APPT)、纤维蛋白原(FIB)、血小板(Plt);回血压、引血压、滤器压及跨膜压(TMP)变化情况。结果治疗后,观察组血肌酐(Scr)及尿素氮(BUN)水平低于对照组(P<0.05),回血压、引血压、滤器压及跨膜压(TMP)低于对照组(P<0.05);两组发生滤器凝血例数比较差异有统计学意义(P<0.05);两组凝血功能指标比较差异无统计学意义(P>0.05)。结论局部枸橼酸钠抗凝能显著提高中高危出血患者血液净化的临床疗效,延长滤器寿命,减少出血及凝血情况发生。Objective To evaluate the value of local natrium citricum anticoagulation in the treatment of continuous blood purification ( CBP) in patients with middle-and high-risk hemorrhage. Methods A total of 54 patients with middle-and high-risk hemorrhage who needed CBP treatment in ICU and Department of Nephropathy of our hospital from February 2013 to February 2018 were selected. They were randomly divided into 2 groups. Non-anticoagulant technique was used in control group ( n = 28). Local natrium citricum anticoagulation technique was used in observation group ( n = 26). The changes in serum creatinine ( Scr),urea nitrogen ( BUN),prothrombin time ( PT), activated partial thromboplastin time ( APPT),fibrinogen ( FIB),platelet ( Plt), return blood pressure, induced blood pressure,filter pressure and transmembrane pressure ( TMP) of the two groups were observed before and after treatment. Results The serum creatinine ( Scr) and urea nitrogen ( BUN) levels of observation group were lower than those of control group ( P < 0. 05). The changes in return blood pressure, induced blood pressure,filter pressure and transmembrane pressure of observation group were lower than those of control group ( P < 0. 05). There was significant difference in the cases of clotting in filter between the two groups ( P < 0. 05). There was no significant difference in the coagulation function indexes between the two groups ( P > 0. 05). Conclusion Local natrium citricum anticoagulation can significantly improve the clinical efficacy of blood purification in patients with middle-and high-risk bleeding,prolong the filter life, and reduce the occurrence of bleeding and coagulation.

关 键 词：枸橼酸钠 抗凝 血液净化 

分 类 号：R692.5[医药卫生—泌尿科学]