连续性静脉静脉血液透析滤过治疗中肝素抗凝与体外枸橼酸钠抗凝的对比研究

The comparing research of anticoagulation with sodium citrate or heparin in continuous venovenous hemodiafil- tration.

目的观察连续性静脉静脉血液透析滤过(CVVHDF)治疗中常规肝素抗凝与体外枸橼酸钠抗凝两种方法的效果与特点。方法多器官功能不全患者50例行连续性静脉静脉血液透析滤过治疗,,按照随机原则分为两组:A 组(体外枸橼酸钠抗凝组)27例,B 组(常规肝素抗凝组)23例,记录治疗前、后的血电解质、酸碱度、凝血指标的变化,管路及血滤器的凝血情况和使用时间,并观察治疗中不良反应。结果治疗过程中两组患者生命体征平稳,电解质、血气指标稳定,肌酐、尿素清除效果明显,超滤可达目标值,A 组血滤器的凝血情况和使用时间优于 B 组,A 组体内凝血时间不受影响,A 组葡萄糖酸钙用量明显大于B组。结论体外枸橼酸钠抗凝对比常规肝素抗凝更有效和更安全。

Objective To investigate the anticoagultive effectiveness and specialty of sodium citrate comparing with hep- arin in continuous venovenous hemodiafiltration (CVVHDF).Methods 50 multiple organ disorder patients undergoing CWHDF were randomly divided into two groups:group A(sodium citrate)27 cases,group B(heparin)23 cases,blood e- lectrolyte,acid-alkali degree,cruor index changes,the blood coagulation of tube path way and blood filter were recor- ded.As the same time,side effects were observed in theraphy.Results The patients of two groups were kept stable vital signs,serum electrolyte and blood gas markers during the therapeutic periods.Moreover,ideal serum creatinine and urea clearance rate and uhrafiltration rate were obtained in all patients.The coagulation and longevity of blood filter of Group A are better than Group B,Group A without sigaificantly prolonged cruor index inside body,the dosage of calcium gluco- nate in Group A are greater than Group B.Conclusion Out body anticongulation of sodium citrate is more effective and reliable than regular heparin anticoagulation.