不同抗凝技术对CRRT滤器使用时间的观察

Observation of Using Time of CRRT Filters with Different Anticoagulant Techniques

对用低分子肝素全身抗凝技术和枸橼酸局部抗凝技术行CRRT治疗的患者进行回顾性分析,比较不同抗凝技术对滤器使用时间的影响。将94例急性肾损伤危重患者按照不同的抗凝方案分为枸橼酸钠组和低分子肝素组,对2组患者的临床资料、活化部分凝血活酶时间(APTT)、凝血酶时间国际标准化比值(INR)、滤器使用时间、治疗效果和治疗过程中出血事件进行统计学比较。结果为2种不同抗凝方式对治疗效果无差异;低分子肝素抗凝的出血风险大于枸橼酸钠局部抗凝;枸橼酸钠局部抗凝技术对CRRT滤器的使用时间明显长于低分子肝素抗凝技术。枸橼酸局部抗凝技术在延长滤器使用时间、减少出血等方面有明显优势,可广泛应用于各种高出血风险的危重症患者CRRT的抗凝治疗。

Objective： To compare using time of filter with different anticoagulant techniques by a retrospective analysis of patients received CRRT treatment using low molecular weight heparin general anticoagulation or citrate regional antieoagulation. Methods： 94 critical patients with acute kidney injury were divided into anti- coagulant sodium citrate group and low molecular weight heparin group according to anticoagulant techniques they received. Clinical information, activated partial thromboplastin time （APTT）, thrombin time, interna- tional normalized ratio （ INR）, filter using time, treatment results and bleeding accidents during treatment were statistically eomparod. Results： There was no difference between treatment effects with the two different anticoagulant techniques. Bleeding risk with low molecular heparin general anticoagulation was higher than that with local sodium citrate local anticoagulation. Using time of CRRT filter with sodium citrate local anti-coagulation technique was longer than that with low-molecular weight heparin anticoagulant technique. Con- clusion： Sodium citrate local anticoagulation technique showed obvious advantages in prolonging using time of filter and reducing bleeding. The technique can be widely used in continuous renal replacement therapy （CRRT） anticoagulant therapy for critical patients with a variety of high bleeding risks.