局部枸橼酸钠抗凝进行连续性肾脏替代治疗在ICU脓毒血症患者中的应用

The application of conducting continuous renal replacement therapy with partial sodium citrate on application on patients with sepsis in ICU

目的：探讨局部枸橼酸钠抗凝进行连续性肾脏替代治疗在 ICU 脓毒血症患者中的应用效果。方法：选取2014年1月~2016年1月入住 ICU 进行连续性肾脏替代治疗的脓毒血症患者60例，随机等分为对照组和试验组，对照组采用低分子肝素抗凝，试验组采用枸橼酸钠局部抗凝；观察两组患者24 h 滤器及管路使用时间及发生出血情况，观察两组24 h 动脉压、静脉压、跨膜压、APTT 的变化，结果：试验组管路及滤器使用时间比对照组长，试验组患者出血发生例数少于对照组。试验组24 h 静脉压、动脉压、跨膜压比对照组低。结论：局部枸橼酸钠抗凝进行连续性肾脏替代治疗在 ICU 脓毒血症患者中使用，既减少患者发生并发症的倾向，又可达到临床治疗效果。

Objective：To explore the application effects of conducting continuous renal replacement therapy with partial sodium citrate on application on pa-tients with sepsis in ICU. Methods：Selected 60 patients with sepsis admitted in ICU for continuous renal replacement treatment from January 2014 to Janu-ary 2016,randomly divided them into control group and experimental group. The patients in control group were treated with low molecular weight heparin, while the patients in the experimental group were treated with regional citrate anticoagulation;observed the 24 h filter and pipeline using time and bleeding condition of the two groups of patients,and observed their 24 h arterial pressure,venous pressure,trans membrane pressure,changes of APTT. Results：Experimental group pipe and filter use time were longer than that of the control group and the bleeding cases of experimental group occurred less than those of the control group. The 24 h venous pressure,arterial pressure and transmembrane pressure were lower than the control group. Conclusion：Using partial sodium citrate to conduct continuous renal replacement therapy on patients with sepsis in the ICU,could both reduce the complication tendency of patients and reach the clinical treatment effects.