局部枸橼酸抗凝在重症急性肾损伤患者连续性肾脏替代治疗中的应用  

Application of Topical Citrate Anticoagulation in Continuous Renal Replacement Therapy in Patients with Severe Acute Kidney Injury

作　　者：孙卫和[1] 许伟伟 冒秀宏[1] 汪涛 SUN Weihe;XU Weiwei;Mao Xiuhong;WANG Tao(Department of Critical Care Medicine,Dongtai People′s Hospital,Dongtai,Jiangsu Province,224200 China)

机构地区：[1]东台市人民医院重症医学科,江苏东台224200

出　　处：《中外医疗》2023年第18期129-132,共4页China & Foreign Medical Treatment

基　　金：盐城市科技计划项目(YK2015082)。

摘　　要：目的探讨局部枸橼酸抗凝对于重症急性肾损伤患者接受连续性肾脏替代治疗中的作用。方法随机选取2019年1月—2022年12月东台市人民医院接诊的重症急性肾损伤患者79例为研究对象,均接受连续性肾脏替代治疗,根据数字表法分为对照组(n=40)和观察组(n=39),对照组实施全身肝素治疗,观察组实施局部枸橼酸抗凝治疗。对比两组患者治疗前后肾功能相关指标、凝血功能指标和治疗结果。结果治疗前,两组患者肾功能指标比较,差异无统计学意义(P>0.05);治疗后,观察组患者肾功能指标较对照组患者更低,差异有统计学意义(P<0.05)。治疗前,两组患者凝血功能指标比较,差异无统计学意义(P>0.05);治疗后,观察组患者凝血功能显著优于对照组,差异有统计学意义(P<0.05)。观察组患者治疗有效率(94.87%)明显高于对照组(75.00%),差异有统计学意义(χ^(2)=6.053,P<0.05)。结论局部枸缘酸抗凝治疗可以明显改善重症急性肾损伤患者在连续性肾脏替代治疗后的肾功能,同时改善患者凝血功能,疗效确切,值得推广。Objective To investigate the role of local citrate anticoagulation in patients with severe acute kidney injury receiving continuous renal replacement therapy.Methods A total of 79 patients with severe acute kidney injury treated by Dongtai People′s Hospital from January 2019 to December 2022 were randomly selected as the study objects.All the patients received continuous renal replacement therapy.According to the numerical table method,they were divided into the control group(n=40)and the observation group(n=39).The control group received systemic heparin therapy and the observation group performed local citrate anticoagulation therapy.The indicators of renal function,coagulation function and treatment outcome were compared before and after treatment between the two groups.Results Before the treatment,the renal function indexes were compared between the two groups,the difference was not statistically significant(P>0.05);after treatment,the renal function of the observation group patients was lower than that of the control group patients,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in coagulation function indicators between the two groups of patients(P>0.05);after treatment,the coagulation function of the observation group patients was significantly better than that of the control group,and the difference was statistically significant(P<0.05).The effective rate of treatment in the observation group(94.87%)was significantly higher than that in the control group(75.00%),and the difference was statistically significant(χ^(2)=6.053,P<0.05).Conclusion Local marginal acid anticoagulation therapy can significantly improve the renal function of patients with severe acute kidney injury after continuous renal replacement therapy,and improve the coagulation function of patients at the same time,with definite efficacy,which is worth promoting.

关 键 词：重症急性肾损伤 连续性肾脏替代治疗 局部枸橼酸抗凝 

分 类 号：R715[医药卫生—妇产科学]