碳酸氢钠溶液不同输注方式对CRRT患者体外循环通路动静脉壶凝血的影响

Influence of Sodium Bicarbonate on Blood Coagulation in the Arterial or Venous Drip Chamber for Continuous Renal Replacement Therapy

目的观察行持续肾脏替代治疗(CRRT)患者碳酸氢钠溶液两种不同输注方式对体外循环通路动静脉壶凝血的影响。方法选择行连续性静脉-静脉血液滤过(CVVH)患者22例,共170例次,全部采用前稀释方式,按碳酸氢钠溶液不同输注方式分为对照组和实验组。对照组直接将碳酸氢钠溶液加入置换液中,钙离子从静脉壶端输入。实验组将碳酸氢钠溶液从静脉壶端输注,钙离子从中心静脉管路输入。观察两组体外循环通路动脉壶和静脉壶出现血凝块的发生率。结果 CRRT采用前稀释方式时实验组静脉壶出现凝血的发生率低于对照组(P<0.05)。结论采用碳酸氢钠溶液从静脉壶端输注能减少体外循环通路静脉壶凝血。

Objective To investigate the Influence of sodium bicarbonate on blood coagulation in the arterial and venous drip chamber with two different infusion method for continuous renal replacement therapy （CRRT）. Methods 170 instances of the 22 patients underwent pre-dilution continuous veno-venous hemofiltration （CVVH） were enrolled and divided into two groups by the infusion method of sodium bicarbonate In the control group, sodium bicarbonate was added to replacement fluid and calcium was infused into the venous drip chamber, while sodium bicarbonate was infused into the venous drip chamber and calcium was infused through central venous catheter in the experiment group. The incidents of blood coagulation in the arterial or venous drip chamber between two groups was recorded. Results The incident of coagulation in the venous drip chamber of the experiment group was lower than that of the control group for pre-dilution Continuous Veno-venous Hemofiltration. Conclusion The infusion of sodium bicarbonate through the venous drip chamber could reduce the incident of blood coagulation in it.