低剂量两段法局部枸橼酸抗凝对高危出血风险患者行含钙透析液血液透析的影响研究

The Effect of Low-dose Topical Citrate Anticoagulation on Calcium Dialysate in Patients with High Risk Bleeding

目的探讨低剂量两段法局部枸橼酸抗凝对高危出血风险患者行含钙透析液血液透析的影响。方法选择纳入我院2020.7-2022.7收治的80例高危出血风险患者行含钙透析液血液透析患者,按照随机法将其分为对照组与研究组,每组各40例,均采用局部枸橼酸抗凝和标准含钙透析液,其中对照组注入常规剂量,设定前段4%枸橼酸钠溶液输注量为血流量的1.5倍;研究组注入低剂量,设定输注量改为1.0倍,比较两组实际抗凝效果。结果两组基线资料对比,差异无统计学意义(P>0.05)。在枸橼酸抗凝不同剂量下,研究组透析器和静脉壶的抗凝有效率均高于对照组(P<0.05),两组干预前凝血功能指标比较无明显差异(P>0.05);两组干预后凝血功能各指标均有所改善,但组间对比不存在统计学差异(P>0.05),研究组透析器前和静脉壶的枸橼酸溶液输注量以及实际血流量均高于对照组(P<0.05)。结论在两段法局部枸橼酸抗凝的基础上,选择低剂量抗凝,不仅能够达到理想的抗凝效果,同时也明显提高透析充分性,是一种安全有效可行的抗凝方案。

Objective To investigate the effect of low-dose two-segment local citrate anticoagulation on hemodialysis of calcium-containing dialysate in patients at high risk of bleeding.Methods The 80 hemodialysis patients with high-risk bleeding admitted to 2020.7-2022.7 were divided into control group and study group.40 patients in each group used local citrate anticoagulation and standard calcium dialysate in the control group was 1.5 times of 4%sodium citrate solution and the low dose to 1.0 times to compare the actual anticoagulant effect of the two groups.Results The baseline data between the two groups was not significant(P>0.05).Under different doses of citrate anticoagulant,the anticoagulant response rate of the dialyzer and venous pot was higher than that in the control group(P<0.05),and there was no significant difference between the two groups(P>0.05),but there was no statistical difference(P>0.05),and the citrate infusion and solution infusion before the dialyzer and venous pot were higher than that in the control group(P<0.05).Conclusion On the basis of local citrate anticoagulation,the method of dialysis is a safe and effective anticoagulation scheme.