低分子肝素与局部枸橼酸抗凝方案用于ICU急性肾损伤患者连续性肾脏替代治疗效果观察  

Watch of the effect of continuous renal replacement therapy in ICU patients with acute kidney injury using low molecular weight heparin and local citrate anticoagulant regimen

作　　者：王廷海 李可欣 刘宣 李宏达 王继锋 王龙 Wang Tinghai;Li Kexin;Liu Xuan;Li Hongda;Wang Jifeng;Wang Long(Beijing Jingxin Hospital,Beijing 100122,China)

机构地区：[1]北京京信医院,北京100122

出　　处：《首都食品与医药》2024年第24期57-59,共3页Capital Food Medicine

摘　　要：目的分析低分子肝素与局部枸橼酸抗凝方案用于重症监护病房(ICU)急性肾损伤患者行连续性肾脏替代(CRRT)治疗的效果。方法纳入2021年2月-2024年6月北京京信医院ICU收治的行CRRT治疗的242例急性肾损伤患者作为研究对象,根据治疗方式不同分为两组,对照组114例患者应用低分子肝素抗凝治疗,观察组128例应用局部枸橼酸抗凝方案。对比两组患者凝血功能指标、滤器使用时间、导管通畅程度及并发症发生率。结果治疗后24h,观察组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)和凝血酶时间(TT)均低于对照组,P<0.05;观察组患者滤器使用时间及导管通畅程度均优于对照组,P<0.05;两组临床并发症发生情况对比:观察组透析管路凝血及出血事件发生率均低于对照组,P<0.05。结论与低分子肝素全身抗凝相比,局部枸橼酸抗凝方案对经CRRT治疗的ICU急性肾损伤患者凝血功能影响更小且安全性更高,更能延长滤器使用时间。Objective To analyze the effect of low molecular weight heparin and local citrate anticoagulation regimen on CRRT in patients with acute kidney injury in the ICU.Methods 242 patients with acute kidney injury treated with CRRT in the ICU of Beijing Jingxin Hospital from February 2021 to June 2024 were chosen.They were split into two teams according to different treatment methods:the control team(114 patients)received low molecular weight anticoagulant therapy,and the watch team(128 patients)received local citrate anticoagulant therapy.Compare the coagulation function indicators,filter usage time,catheter patency,and incidence of complications between two teams of patients.Results After 24 hours of treatment,the APTT,PT,and TT of the watch team were all lower than those of the low molecular weight heparin team,P<0.05.The filter usage time and catheter patency of the watch team were better than those of the control team,P<0.05.Comparison of clinical complications between the two teams:the incidence of coagulation and bleeding time in the dialysis tubing of the watch team was lower than that of the control team,P<0.05.Conclusion Compared with low molecular weight heparin systemic anticoagulation,the local citrate anticoagulation regimen has a smaller impact on coagulation function and higher safety in ICU acute kidney injury patients treated with CRRT,and can prolong the filter usage time more effectively.

关 键 词：局部枸橼酸抗凝 低分子肝素 ICU CRRT 急性肾损伤 

分 类 号：R692[医药卫生—泌尿科学]