枸橼酸钠抗凝在连续性血液灌流中的应用

Sodium citrate for anticoagulation in continuous hemoperfusion

目的:评价枸橼酸钠抗凝在连续性血液灌流中的抗凝效果。方法:将35例实施连续性血液灌流的重度有机磷中毒患者根据抗凝方案分为低分子肝素组和枸橼酸钠组。比较2组治疗过程中跨膜压的变化,同时比较治疗后血小板、部分凝血活酶时间、HCO-3、游离钙、Na+和24 h内出血情况。结果:低分子肝素组治疗2 h和治疗4 h的跨膜压均较枸橼酸钠组明显增高(P<0.01);治疗后低分子肝素组部分凝血活酶时间较枸橼酸钠组明显延长(P<0.01);2组治疗后血小板、HCO-3、游离钙和Na+差异均无统计学意义(P>0.05)。结论:在连续性血液灌流过程中应用枸橼酸钠抗凝具有可行性和安全性。

Objective： To evaluate the anticoagulation effect of sodium citrate in continuous hemoperfusion. Methods： Thirty-five patients with severe organophosphorus pesticide poisoning were treated by continuous hemoperfusion using low-molecular-weight heparins or sodium citrate for anticoagulation. The changes of transmembrane pressure during the treatment were compared between the 2 groups; meanwhile, the platelet, APTT, HCO3-, iCa2＋ , Na＋ after treatment and the incidence of bleeding within 24 hours were also compared. Results：Compared with the sodium citrate group, the transmembrane pressures of the low-molecular-weight heparins group at 2 h and 4 h after treatment were increased significantly（ P 〈 0.01 ） ;after treatment, the AP＇IT were extended significantly（ P 〈 0.01 ）, but the platelet, HCO3- , iCa2＋ and Na＋ had no obviously changes（ P 〉 0.05 ）. Condnsions：It is feasible and safe to use sodium citrate for anticoagulation in the continuous hemoperfusion.