枸橼酸钠局部抗凝在血液净化中的临床效果  

Clinical effect of local anticoagulation of sodium citrate in blood purification in intensive care department

作　　者：邱顺年 林春丽 兰旻 徐林梅[2] QIU Shunnian;LIN Chunli;LAN Min;XU Linmei(Department of Critical Care Medicine,Jiangle General Hospital of Fujian Province,Fujian Province,Jiangle County 365000,China;不详)

机构地区：[1]福建省将乐县总医院重症医学科,365000 [2]厦门大学附属第一医院,福建省厦门市361000

出　　处：《临床合理用药杂志》2022年第10期34-36,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察枸橼酸钠局部抗凝在血液净化中的临床效果。方法选择2018年12月—2019年9月在福建省将乐县总医院及厦门大学附属第一医院接受治疗的血液净化患者68例,采用随机数字表法分为观察组和对照组,每组34例。对照组采取低分子肝素抗凝,观察组采取枸橼酸钠局部抗凝治疗。比较2组患者治疗前后凝血功能、血液生化指标及并发症。结果治疗前后观察组患者活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)比较差异无统计学意义(P>0.05),治疗后,对照组患者APTT、PT、TT明显长于治疗前及观察组,差异均有统计学意义(P<0.01);治疗后,2组血离子钙(iCa^(2+))、碳酸氢根(HCO_(3)^(-))、钠离子(Na^(+))和血肌酐(SCr)比较差异均有统计学意义(P<0.05);观察组患者的并发症总发生率为14.7%,明显低于对照组的67.6%(χ^(2)=19.671,P<0.001)。结论血液净化中运用枸橼酸钠局部抗凝的效果显著,患者出血风险低,具有较高临床应用价值。Objective To observe the clinical effect of local anticoagulation of sodium citrate in blood purification.Methods 68 patients with blood purification who received treatment in Jiangle General Hospital of Fujian Province and the First Affiliated Hospital of Xiamen University from December 2018 to September 2019 were selected,and they were divided into observation group and control group by random number table method,34 patients in each group.The control group was given low molecular weight heparin for anticoagulation,and the observation group was given local anticoagulation with sodium citrate.The coagulation function,blood biochemical indexes and complications were compared before and after treatment between the two groups.Results There were no significant difference in activated partial thromboplastin time(APTT),prothrombin time(PT)and thrombin time(TT)in the observation group before and after treatment(P>0.05).After treatment,the APTT,PT and TT of the control group were significantly longer than those before treatment and the observation group,and the differences were statistically significant(P<0.01);After treatment,there were significant differences in serum ionized calcium(iCa^(2+)),bicarbonate(HCO_(3)^(-)),sodium ion(Na^(+))and serum creatinine(SCr)between the two groups(P<0.05);The total incidence of complications in the observation group was 14.7%,which was significantly lower than 67.6%in the control group,and the difference was statistically significant(χ^(2)=19.671,P<0.001).Conclusion The use of sodium citrate for local anticoagulation in blood purification has a significant effect,and the bleeding risk of patients is low,which has high clinical application value.

关 键 词：血液净化 重症医学科 枸橼酸钠 局部抗凝 临床应用 

分 类 号：R459.5[医药卫生—治疗学]