抗凝剂在连续性肾脏替代疗法中的应用进展

Application progress of anticoagulant agent in continuous renal replacement therapy

连续性肾脏替代疗法(CRRT)被越来越多地应用于临床。但在CRRT过程中最大的不利是需要延长抗凝来防止体外回路中血液凝固。本文通过对CRRT治疗方法和抗凝剂的历史回顾,对各种抗凝机制进行详细论述并对各种抗凝方法优缺点进行比较,使我们对CRRT过程中使用的抗凝剂有更深入的了解,掌握CRRT过程中使用抗凝剂的最新研究进展,从而指导我们根据患者实际情况选择最佳的抗凝方法。既能保证活动性出血及高危出血患者的安全问题,避免损失血液及加重出血,又能保证透析质量及降低透析成本。

Continuous renal replacement therapy （CRRT） is more and more applied in clinic. But the biggest disadvantage in the process of CRRT is the need to extend the time of anticoagulation to prevent blood coagulation in extracorporeal circulation. We can lead to deeper understanding of the application of anticoagulant agent during the CRRT through reviewing therapeutic methods and the history of CRRT, and particular introducing a variety of anticoagulant mechanism as well as comparing the merit and demerit of the various anticoagulant method of CRRT, mastering the latest progress in the use of anticoagulants in the process of CRRT, so as to guide our patients to choose the best anticoagulant based on the practical situation, which could ensure the safety of active bleeding and the patients at high risk of bleeding problems, avoid the loss of blood and increase the bleeding, and can ensure the quality and reduce cost of dialysis.