CAJ | 학술논문

目的探讨含枸橼酸钠的置换液的配制及其在血液滤过中的抗凝有效性和安全性.方法 12只健康犬随机分为2组,枸橼酸钠组:使用含1.5mmol/L枸橼酸钠的置换液,在血滤管路静脉端持续补钙;肝素组:使用低分子肝素[20U/(kg·h)]持续泵入;记录血液滤过前、血液滤过后每2小时的血肌酐、尿素、血气分析、电解质、凝血功能(PT、PT%、PT/R、PT INR、APTT、AT3%及Fbg等)的变化、管路及血滤器的凝血情况和使用时间.结果两组血液滤过治疗过程中均未有管路和血滤器堵塞现象,实验犬电解质、血气分析相同,血浆的肌酐、尿素结果两组无明显差异(P＜0.01),枸橼酸钠组的实验犬体内的PT、PT%、PT/R、PT INR、APTT、AT3%均不延长,纤维蛋白原浓度(Fbg)没有明显下降;与之比较,肝素组在血流量为50ml/h,置换液速度500ml/h时,体内的PT、PT INR、APTT均有延长(P＜0.01).结论枸橼酸盐置换液应用血液滤过治疗时,有良好的抗凝效果,同时,不会对体内凝血功能及内环境产生不良影响.
목적 탐토함구연산납적치환액적배제급기재혈액려과중적항응유효성화안전성.방법 12지건강견수궤분위2조,구연산납조:사용함1.5mmol/L구연산납적치환액,재혈려관로정맥단지속보개;간소조:사용저분자간소[20U/(kg·h)]지속빙입;기록혈액려과전、혈액려과후매2소시적혈기항、뇨소、혈기분석、전해질、응혈공능(PT、PT%、PT/R、PT INR、APTT、AT3%급Fbg등)적변화、관로급혈려기적응혈정황화사용시간.결과 량조혈액려과치료과정중균미유관로화혈려기도새현상,실험견전해질、혈기분석상동,혈장적기항、뇨소결과량조무명현차이(P＜0.01),구연산납조적실험견체내적PT、PT%、PT/R、PT INR、APTT、AT3%균불연장,섬유단백원농도(Fbg)몰유명현하강;여지비교,간소조재혈류량위50ml/h,치환액속도500ml/h시,체내적PT、PT INR、APTT균유연장(P＜0.01).결론 구연산염치환액응용혈액려과치료시,유량호적항응효과,동시,불회대체내응혈공능급내배경산생불량영향.
Objectivs To investigate the anticoagulative effectiveness and reliability of sodium citrate substitution fluid in hemofiltration.Methods 12 healthy hybridize dogs were randomly divided into two groups:sodium citrate substitution fluid was used during hemofihration in treatment group and hepafin was continuously pumped in control group.12 hours after acute kidney failure in dogs,each group was given hemoflltration.Blood gas analysis,serum creatinine,blood urea nitrogen (BUN),electrolyte and blood clotting function including prothrombin time (PT),PT%,PT/B,PT INR,activated partial thromboplastin time(APTT),AT3%,thromboplastin time(TT) and Fbg were recorded at pre-dialysis,per 2 hour in dialysis.The blood coagulation of tube pathways and blood filters were observed.Results All animals were kept stable vital signs.There were no significant deferences between two groups in serum electrolyte,blood gas analysis,serum creatinine and urea clearance rate,and the blood filters were longevital during the therapeutic periods.Those of PT,PT%,PT/R,PT INR,APTT,TT,AT3% were no significantly prolonged in treatment group.Compared with treatment group,those of PT,PT INR and AP'IT were prolonged in control group while blood flow was 50 ml/h,replacement fluid is 500 ml/h.Conclusion Ideal therapeutic effects and improved hemorrhagic tendency were achieved in using sodium citrate substitution fluid during hemofiltration.