重症急性肾损伤患者连续性肾脏替代疗法中应用那屈肝素钙与枸橼酸钠抗凝的效果比较  

Comparison of the Effects of Application of Nadroparin Calcium and Sodium Citrate Anticoagulation in Continuous Renal Replacement Therapy in Patients with Severe Acute Kidney Injury

作　　者：王宝 WANG Bao(Department of Critical Care Medicine,Xuzhou Jiawang District People's Hospital,Xuzhou 221611,Jiangsu,China)

机构地区：[1]徐州市贾汪区人民医院重症医学科,江苏徐州221611

出　　处：《系统医学》2024年第12期54-57,共4页Systems Medicine

摘　　要：目的 比较那屈肝素钙与枸橼酸钠用于重症急性肾损伤(Acute Kidney Injury,AKI)患者连续性肾脏替代疗法(Continuous Renal Replacement Therapy,CRRT)中的抗凝效果差异。方法 目的选取2022年1月—2023年12月徐州市贾汪区人民医院重症医学科收治的80例重症AKI患者为研究对象,按治疗方法差异分为对照组(应用那屈肝素钙治疗)与观察组(应用枸橼酸钠治疗),每组40例。对比两组的抗凝效果,凝血、肾功能恢复情况及并发症情况。结果 观察组抗凝有效率(95.00%)高于对照组(75.00%),观察组并发症发生率(7.50%)低于对照组(30.00%),差异有统计学意义(χ^(2)=6.275、6.646,P均<0.05)。治疗后,观察组患者活化部分凝血活酶时间长于对照组,肌酐清除率高于对照组,纤维蛋白原、D-二聚体、尿素氮、血肌酐均低于对照组,差异有统计学意义(P均<0.05)。结论 对重症AKI患者来说,在CRRT治疗中那屈肝素钙的抗凝效果较枸橼酸钠更优,且在改善凝血功能方面的价值突出,对患者肾功能恢复具有积极影响,可降低并发症风险。Objective To compare the difference in anticoagulation effect between nadroparin calcium and sodium citrate in continuous renal replacement therapy(CRRT) for patients with severe acute kidney injury(AKI).Methods 80patients with severe AKI admitted to the Department of Critical Care Medicine of Xuzhou Jiawang District People's Hospital during from 2022 to December 2023 were purposefully selected as the study objects,and were divided into the control group(treated with nadroparin calcium) and the observation group(treated with sodium citrate) according to different treatment methods,with 40 cases in each group.The anticoagulation effect,coagulation,renal function recovery and complications of the two groups were compared.Results The anticoagulation effective rate of the observation group(95.00%) was higher than that of the control group(75.00%),and the complication rate of the observation group(7.50%) was lower than that of the control group(30.00%),and the differences were statistically significant(χ^(2)=6.275,6.646,both P<0.05).After treatment,the activated partial thromboplastin time of patients in the observation group was longer than that of the control group,the creatinine clearance rate was higher than that of the control group,and the fibrinogen,D-dimer,urea nitrogen,and blood creatinine were lower than those of the control group,the differences were statistically significant(all P<0.05).Conclusion For patients with severe AKI,the anticoagulant effect of nadroparin calcium in CRRT treatment is better than that of sodium citrate,and its value in improving coagulation function is outstanding,which has a positive impact on the recovery of renal function of patients,and can reduce the risk of complications.

关 键 词：重症急性肾损伤 连续性肾脏替代疗法 那屈肝素钙 枸橼酸钠抗凝 凝血指标 肾功能 

分 类 号：R692[医药卫生—泌尿科学]