局部枸橼酸抗凝在肝衰竭患者连续血液净化治疗中的应用进展

Application Progress of Regional Citrate Anticoagulation in Continuous Blood Purification Therapy for Patients with Liver Failure

连续性血液净化治疗作为救治肝衰竭患者的重要支持方式之一,为保证其顺利进行,正确合理抗凝至关重要。局部枸橼酸抗凝具有出血风险小、滤器寿命长等显著优势,但肝衰竭患者枸橼酸代谢清除能力下降,发生枸橼酸蓄积等并发症的风险增加故限制了其使用。通过阅读近年来国内外相关文献,就局部枸橼酸抗凝在肝衰竭患者中的安全性、有效性、抗凝风险及评估模型的建立进行综述。

For patients with liver failure, continuous blood purification therapy is one of the most important therapeutic methods. It is vital that anticoagulate correctly and reasonably to complete this process smoothly. Regional citrate anticoagulation reduced the risk of bleeding and prolonged the filter lifetime, whereas patients with liver failure had decreased ability of citrate metabolism and in-creased risk complications such as citrate concentration. By reading relevant literature at home and abroad, the review summarized the safety, effectiveness, risk of RCA and evaluation model.