血液净化:抗凝的策略  

Blood purification:strategies for anticoagulation

作　　者：肇冬梅[1] 马晓春[1] ZHAO Dong-mei;MA Xiao-chun(Department of Critical Care Medicine,the First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院重症医学科,辽宁沈阳110001

出　　处：《中国实用内科杂志》2023年第12期996-999,共4页Chinese Journal of Practical Internal Medicine

基　　金：国家重点研发计划(2021YFC2500805)。

摘　　要：连续性肾脏替代治疗(CRRT)被广泛用于治疗危重患者。CRRT期间需要抗凝治疗以防止体外循环凝血,然而抗凝剂种类繁多,危重症患者抗凝需求不一,迄今仍缺乏针对危重症患者CRRT的抗凝策略。文章基于新近的研究证据和临床经验,阐述各种抗凝方式的选择、适应证、原理、参数设置、监测及并发症,为临床治疗提供参考。Continuous renal replacement therapy(CRRT)is widely used to treat critically ill patients.Anticoagulant therapy is required to prevent coagulation during CRRT.However,there are various types of anticoagulants,and the anticoagulant needs of critically ill patients vary.Therefore,there is still a lack of anticoagulant strategies for CRRT in critically ill patients.Based on the latest research evidence and clinical experience,this article elaborates on the selection,indications,mechanism,parameter settings,monitoring,and complications of various anticoagulation methods,in order to provide reference for clinical treatment.

关 键 词：连续性肾脏替代治疗 抗凝药物 局部枸橼酸抗凝 全身抗凝 肝素 

分 类 号：R692.5[医药卫生—泌尿科学]