脓毒症急性肾损伤患者CRRT治疗中应用枸橼酸抗凝与全身肝素化抗凝的效果分析及对凝血功能和肾功能的影响  

Analysis of the Effect of Citrate Anticoagulation and Systemic Heparinized Anticoagulation in CRRT Treatment of Patients with Acute Renal Injury in Sepsis and Its Effect on Coagulation Function and Renal Function

作　　者：黄选辉 HUANG Xuanhui(Huizhou Third People’s Hospital,Huizhou 516002,China)

机构地区：[1]广东省惠州市第三人民医院,广东惠州516002

出　　处：《中国医学创新》2020年第4期71-74,共4页Medical Innovation of China

摘　　要：目的:比较枸橼酸抗凝与全身肝素化抗凝对脓毒症急性肾损伤患者CRRT治疗中的效果。方法:选取2018年1月-2019年5月本院收治的114例脓毒症急性肾损伤患者为研究对象,采用随机数字表法,将其分为研究组与常规组,每组57例。常规组在CRRT治疗过程中给予全身肝素化抗凝治疗,研究组在CRRT治疗过程中给予枸橼酸抗凝治疗。比较两组患者治疗前后的凝血功能、肾功能,同时比较两组患者的滤器使用寿命及不良反应发生情况。结果:治疗后,两组两组的PT与APTT均高于治疗前,且常规组上述指标均高于研究组,差异均有统计学意义(P<0.05);治疗后,两组患者的PLT值均低于治疗前,且常规组低于研究组,差异均有统计学意义(P<0.05);治疗后,两组患者BUN、Scr水平均低于治疗前,且研究组均低于常规组,差异均有统计学意义(P<0.05);研究组滤器的平均使用寿命长于常规组,差异有统计学意义(P<0.05);治疗后,研究组的出血事件发生率为33.33%,显著低于常规组的3.51%,差异有统计学意义(P<0.05)。结论:经研究得知,脓毒症急性肾损伤患者在实施CRRT治疗时,应用枸橼酸抗凝的效果显著优于全身肝素化抗凝效果,能够改善患者的肾功能,延长滤器的使用时间,值得在临床中推广应用。Objective:To compare the effect of anticoagulation of citrate and systemic heparinization on CRRT in patients with acute renal injury of sepsis.Method:A total of 114 patients with acute kidney injury with sepsis admitted to our hospital from January 2018 to May 2019 were selected as the study objects.According the random number table method,they were divided into the study group and the conventional group,57 cases in each group.The conventional group was given systemic heparinized anticoagulant therapy during CRRT treatment,the study group was treated with anticoagulant citrate during CRRT.The coagulation function and renal function of the two groups of patients before and after treatment were compared,and the filter service life and adverse reactions of the two groups of patients were compared.Result:After treatment,both groups had higher PT and APTT than those before treatment,and the above indicators in the conventional group were all higher than those in the study group,the differences were statistically significant (P<0.05).After treatment,PLT values in both groups were lower than those before treatment,and the conventional group was lower than the study group,the differences were statistically significant (P<0.05).After treatment,the levels of BUN and Scr in both groups were lower than those before treatment,and the study group were lower than those in the conventional group,the differences were statistically significant (P<0.05).The average service life of the study group filters was longer than that of the conventional group,the difference was statistically significant (P<0.05).After treatment,the incidence of bleeding events in the study group was 33.33%,significantly lower than the 3.51% in the conventional group,the difference was statistically significant (P<0.05).Conclusion:According to the study,the anticoagulation effect of citrate is significantly better than that of systemic heparinization in the CRRT treatment of patients with acute renal injury of sepsis,which can improve the renal function of

关 键 词：脓毒症急性肾损伤 CRRT治疗 枸橼酸抗凝 全身肝素化抗凝 

分 类 号：R459.7[医药卫生—急诊医学] R692.5[医药卫生—治疗学]