局部枸橼酸抗凝在脓毒症急性肾损伤患者连续性肾替代治疗(CRRT)中的应用研究  

Application of topical citrate anticoagulation in continuous renal replacement therapy(CRRT)in patients with septic acute kidney injury

作　　者：李剑锋 张卫芳 钟景兴 彭绵[1] 陶龙城 杨正月 李翠容 LI jianfeng;ZHANG Weifang;ZHONG Jingxing;PENG Mian;TAO longcheng;YANG Zhengyue;LI Cuirong(Department of Intensive Care Unit,The People’s Hospital of Luohu District,Shenzhen 518001,China)

机构地区：[1]深圳市罗湖区人民医院,广东深圳518001

出　　处：《包头医学院学报》2021年第3期3-6,共4页Journal of Baotou Medical College

基　　金：深圳市罗湖区科技计划项目(LX20191407)。

摘　　要：目的:探讨局部枸橼酸抗凝在脓毒症急性肾损伤患者连续性肾替代治疗(CRRT)中的应用效果。方法:选取2019年3月至2020年12月收治的110例脓毒症急性肾损伤患者作为研究对象,分为A、B两组,两组均给予CRRT治疗,A组采用局部枸橼酸抗凝,B组采用全身肝素抗凝,比较两组治疗前后肾功能指标、凝血功能指标、酸碱指标及临床效果指标。结果:治疗前两组血尿素氮(BUN)、血肌酐(Scr)、凝血功能指标水平差异无统计学意义(P>0.05),治疗后A组BUN、Scr指标水平、凝血酶原时间(PT)、活化部分凝血时间(APTT)、血小板计数(PLT)指标水平改善程度均优于B组(P<0.05);治疗前后两组HCO-3、pH值指标水平差异均无统计学意义(P>0.05);A组滤器使用寿命较B组长,出血发生率低于B组,ICU住院时间少于B组(P<0.05)。结论:局部枸橼酸抗凝应用于脓毒症急性肾损伤CRRT患者可显著改善患者肾功能指标,改善患者凝血功能,安全性更好,值得推广。Objective:To investigate and analyze the application effect of topical citrate anticoagulation in continuous renal replacement therapy(CRRT)in patients with septic acute kidney injury.Methods:A total of 110 patients with acute kidney injury with sepsis admitted from March 2019 to December 2020 were selected as the research subjects and divided into two groups,group A and group B.Both groups were given CRRT treatment.Group A was given local citrate anticoagulation,and group B was given systemic heparin anticoagulation.Renal function indexes,coagulation function indexes,acid-base indexes and clinical effect indexes were compared between the two groups before and after treatment.Results:There was no significant difference in the levels of BUN,Scr,and coagulation function between the two groups before treatment(P>0.05).After treatment,the levels of BUN,SCR,prothrombin time(PT),activated partial coagulation time(APTT)and platelet count(PLT)in group A were better than those in group B(P<0.05).There were no significant differences in HCO3-and pH levels between the two groups before and after treatment(P>0.05).The service life of the filter in group A was longer than that in group B,the bleeding rate was lower than that in group B,and the ICU hospitalization time in group A was shorter than that in group B(P<0.05).Conclusion:The application of topical citrate anticoagulation in CRRT patients with septic acute renal injury can significantly improve the renal function indexes and improve the coagulation function of patients,with better safety and worthy of promotion.

关 键 词：局部枸橼酸抗凝 脓毒症 急性肾损伤 连续性肾替代治疗 

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