局部枸橼酸钠抗凝血液净化在高危出血患者中的应用研究

Application of continuous blood purification with regional citrate anticoagulation to renal failure patients at high risk of bleeding

目的评价局部枸橼酸钠抗凝法血液净化在高危出血患者中应用的临床效果及安全性。方法回顾2009年10月—2014年12月需要行连续肾脏替代治疗的高危出血患者42例,分析治疗前后血肌酐(SCr)、尿素氮(BUN)及钾离子(K+)浓度的变化;血清凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)及国际标准化比值(INR)的变化。结果 42例患者行局部枸橼酸钠抗凝法血液净化后SCr、BUN及K+浓度比治疗前明显降低,差异有统计学意义(P<0.01);PT、APTT、TT及INR与治疗前比较无明显变化,差异无统计学意义(P>0.05)。结论局部枸橼酸钠抗凝法血液净化在高危出血患者中应用是安全有效的。

Objective To assess the safety and efficacy of continuous blood purification with regional citrate anticoagulation to renal failure patients at high risk of bleeding. Methods 42 cases of renal failure patients at high risk of bleeding from October 2009 to December 2014 were retrospectively analyzed. Serum Crea、Urea、K＋、PT、APTT、TT and INR Levels were monitored pre and post-CVVH. Results Serum Crea、Urea and K＋ levels were significantly different pre and post-CVVH,and there was statistical significance（P〈0.01）.PT、APTT、TT and INR Levels were not significantly different pre and post-CVVH,and there was not statistical significance（P〉0.05）.Conclusion Continuous blood purification with regional citrate anticoagulation to renal failure patients at high risk of bleeding is safe and effective.