对比分析局部枸橼酸抗凝与全身低分子肝素抗凝在重症结核病患者CRRT中的临床效果与安全性

Comparative Analysis of Clinical Efficacy and Safety of Local Citrate Anticoagulation and Systemic Low-molecular-weight Heparin Anticoagulation in CRRT of Patients with Severe Tuberculosis

目的:对比分析局部枸橼酸抗凝与全身低分子肝素抗凝在重症结核病患者连续性肾脏替代治疗(CRRT)中的临床效果与安全性。方法:选取我院2021年10月到2023年9月60例采取CRRT治疗的重症结核病患者,分为观察组(局部枸橼酸抗凝)与对照组(全身低分子肝素抗凝),各30例。对比两组的血常规、肝肾功能指标、预后水平,及并发症。结果:治疗后两组患者PLT水平均降低,INR、APTT水平均升高,具有统计学意义(P<0.05);治疗后两组患者Scr、BUN水平、SOFA、APACHEⅡ评分均降低,且观察组与对照组比较有差异(P<0.05);观察组过滤器使用寿命高于对照组,出血发生率低于对照组(P<0.05)。结论:针对重症结核病患者采取局部枸橼酸抗凝效果较好,同时采取局部枸橼酸抗凝可在提升抗凝效果的同时,改善肾功能,改善患者预后水平,提升过滤器使用寿命,降低出血发生率。

Objective:To compare the clinical efficacy and safety of local citrate anticoagulation and systemic low-molecular-weight heparin anticoagulation in CRRT for patients with severe tuberculosis.Methods:From October 2021 to September2023,60 patients with severe tuberculosis who were treated with CRRT in our hospital were selected and divided into the observation group(local citrate anticoagulation)and the control group(systemic low-molecular-weight heparin anticoagulation),30 patients in each group.Compare the blood routine,liver and kidney function indicators,prognosis level,and incidence of complications between the two groups.Result:After treatment,PLT levels decreased in both groups of patients,while INR and APTT levels increased,with statistical significance(P<0.05);After treatment,the Scr,BUN levels,SOFA,and APACHEⅡscores of both groups of patients decreased,and there was a significant difference between the observation group and the control group(P<0.05);The service life of the observation group filter was higher than that of the control group,and the incidence of bleeding was lower than that of the control group(P<0.05).Conclusion:For severe tuberculosis patients,local citrate anticoagulation is better,while local citrate anticoagulation can improve the renal function,improve the prognosis of patients,improve the service life of the filter,and reduce the incidence of bleeding.