4％枸橼酸钠溶液在中心静脉置管血液透析患者中的应用

Application of 4 % sodium citrate lock solution in patients with temporary indwelling central vein catheter

目的观察4％枸橼酸钠封管液在临时性中心静脉置管血液透析患者中的应用。方法将61例维持性血液透析患者随机分为2组，即4%枸橼酸钠封管组30例，肝素钠封管组31例。每次透析结束后，对2组患者分别以4％枸橼酸钠和肝素钠封管，均连续使用5周。评价2组患者导管相关的出血、感染和导管功能不良情况。结果①4％枸橼酸钠封管组导管相关的出血事件发生率较肝素钠封管组低，差异有统计学意义（P〈0．05）。②4％枸橼酸钠封管组有1例次出现透析中发热，但导管液和血液细菌培养均为阴性，肝素钠封管组有1例患者出现透析中发热，导管液培养为金黄色葡萄球菌阳性，血培养为阴性。③2组患者导管功能不良发生率无显著差异（P〉0．05）。结论对于临时性中心静脉置管的血液透析患者，4％枸橼酸钠封管液可作为常规肝素钠封管液的替代。

Objective To study the efficacy and safety of 4% sodium citrate versus heparin catheter lock solution in patients with temporary indwelling central vein catheter. Methods Sixty-one maintenance hemodialysis patients with temporary catheters were divided into 2 groups randomly. The patients in citrate group received 4% sodium citrate lock for catheters after each dialysis session for 5 weeks, while those in control group with heparin lock solution. The catheter-related hemorrhage complications, infectionand catheter function were compared between two groups. Results （1）The cathe- ter-related hemorrhage complications rate in citrate group was significantly lower than in control group （P〈0.05）. （2）In citrate group, only 1 case was positive for bacterial culture in catheter lock solution and no oral lips numbness side effect was found. （3）The catheter function had no difference between two groups（P〉0.06）. Conclusion 4% sodium citrate solution is an alternative lock solution in hemodialysis patients with temporary catheters.