局部枸椽酸钠抗凝法与肝素抗凝法在CRRT中的应用比较

Comparative study on regional citrate anticoagulation and the heparin law used in the application of CRRT

目的比较局部枸椽酸钠抗凝法与肝素抗凝法在CRRT中的应用效果。方法将我院2011年11月至2012年12月行CRRT治疗的126例患者随机分为两组，肝素抗凝组患者采用常规肝素抗凝方式治疗，局部枸椽酸钠抗凝组患者采用局部枸椽酸钠抗凝方式治疗。结果治疗后局部枸椽酸钠抗凝组患者未出现高钠血症和代谢性碱中毒情况；治疗后肝素抗凝组患者的体内钙离子浓度明显下降，局部枸椽酸钠抗凝组明显上升，两组比较差异有统计学意义俨〈0．05）。结论在CRRT治疗中，局部枸椽酸钠抗凝比常规肝素抗凝更有效、更安全。

Objective To compare the clinical effects of regional citrate anticoagulation with heparin sodium anticoagulation method in the application of continuous renal replacement therapy （CRRT）. Methods In our hospital from November 201l to December 2012, 126 cases of CRRT were randomly divided into 2 groups, namely regional citrate anticoagulation group and heparin group. Heparin group was treated with conventional heparin anticoagulation therapy, regional citrate anticoagulation group was treated by regional citrate anticoagulation treatment. Results After treatment of regional citrate anticoagulation group patients did not appear hypernatremia and metabolic alkalosis; after treatment with heparin patients with total body calcium concentration decreased significantly, regional citrate anticoagulation group increased obviously. With comparison of the two groups, the difference was statistically significant （P〈0.05）. Conclusion In the treatment of CRRT, regional citrate auticoagulation is more effective and safer than heparin anticoagulation