局部枸橼酸抗凝在肝衰竭患者连续性肾脏替代治疗中的应用  

Clinical application of regional citrate anticoagulation in continuous renal replacement therapy for patients with liver failure

作　　者：金源源 诸炳骅[1] 费雪洁[1] 王倩[1] JIN Yuanyuan;ZHU Binghua;FEI Xuejie;WANG Qian(Department of Emergency,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院急诊内科,上海201203

出　　处：《临床肝胆病杂志》2021年第1期200-203,共4页Journal of Clinical Hepatology

基　　金：上海申康医院发展中心临床科技创新项目(SHDC12017X23)。

摘　　要：体外抗凝是连续性肾脏替代治疗(CRRT)的一项关键技术,肝素曾是CRRT首选的抗凝剂,但由于出血风险高,临床使用受限。枸橼酸作为一种新型局部抗凝剂,近年来受到越来越多的关注和推荐,但对于肝衰竭患者的应用一直存在争议。通过阅读近年来国内外相关文献,就局部枸橼酸抗凝在肝衰竭患者中的代谢特点、监测方法及其在CRRT应用中的安全性进行综述。In vitro anticoagulation is a key technique in continuous renal replacement therapy(CRRT),and heparin was once the preferred anticoagulant for CRRT,but its clinical application is limited due to the high risk of bleeding.Citrate,as a new regional anticoagulant,has received more and more attention and recommendation in recent years,but there are still controversies over its application in patients with liver failure.With reference to relevant literature in China and globally,this article reviews the metabolic characteristics and monitoring methods of regional citrate anticoagulation and its safety in CRRT for patients with liver failure.

关 键 词：肝功能衰竭 枸橼酸 肾替代疗法 

分 类 号：R575.3[医药卫生—消化系统] R459.5[医药卫生—内科学]