枸橼酸钠用于维持性血液透析留置导管封管的临床观察

Clinical observation on the sodium citrate as locking solution to hemodialysis catheters

目的观察4%枸橼酸钠用于维持性血液透析临时导管封管的有效性和安全性。方法将2010年2～12月我院透析中心维持性血液透析患者27例随机分为两组,以seldinger法建立临时透析导管。对照组采用30%肝素盐水封管;试验组采用4%枸橼酸钠封管。分析两组死亡病例数、导管相关并发症等资料,比较4%枸橼酸钠用于透析导管封管的有效性和安全性。结果 (1)纳入患者27例,其中对照组13例,试验组14例,平均(47.45±17.36)岁,研究期间死亡病例1例,退出研究1例;(2)两组患者导管相关并发症,意外拔管例数差异无统计学意义(P>0.05);(3)两组患者血小板、钙离子、转氨酶及血pH无明显变化(P>0.05);(4)意向性分析显示退出患者对结果无显著影响。结论枸橼酸钠对于维持性透析导管封管有一定的应用前景,值得推广。

Objective To observe the efficacy and safety of locking solution with 4% sodium citrate for hemodialysis catheter. Methods 27 patients were enrolled in this study during February 2010 to December 2010 in our dialysis center. Randomly,all patients were divided in to two group including control group with locking solution of 30% heparin saline and treatment group with locking solution of 4% sodium citrate. Analyzed the number of death,catheter-related complications and so on in both groups to compare the efficacy and safety of locking solution with 4% sodium citrate for hemodialysis catheter. Results（1） 27 cases with average age（47.45±17.36） years old were enrolled including 13 cases in the control group and 14 cases in treatment group. There were 1 death case and 1 drop-out case during the study.（2） There were no significant difference with the number of death and the cases of extubation by accident;（3） The level of platelet,calcium,ALT and blood PH were no significant change（P 0.05）;（4） With ITT analysis,there was no significant change（P0.05） . Conclusion Sodium citrate as locking solution for hemodialysis catheter with a certain prospect should be promoted.