CAJ | 학술논문

目的：通过回顾性分析比较枸橼酸钠与肝素抗凝在CRRT 治疗中的应用。方法纳入54例患者，随机分为两组，分别接受枸橼酸钠，低分子肝素预冲CRRT，同步抗凝，比较凝血指标、电解质和酸碱平衡以及滤器管路寿命。结果枸橼酸盐组血液透析器使用时间明显长于低分子肝素组。枸橼酸盐组在血液透析中APTT、PT与低分子肝素组比较，差异均有统计学意义（ P＜0．05），应用枸橼酸钠局部抗凝后血滤管道内血液的凝血指标（APTT、PT）延长，经过滤器后凝血指标变化不大（P＞0．05），体内静脉血凝血指标恢复正常范围内；低分子肝素组滤器前后管道中凝血指标变化不大（P＞0．05），与枸橼酸钠组比较，低分子肝素组在体内的（ APTT、PT）均延长。结论枸橼酸钠抗凝方式安全有效，适于推广。在透析过程中密切观察，依据动脉血气，电解质结果调整枸橼酸钠剂量，使每次血液滤过治疗顺利有效地进行，是治疗成功的保障。
목적：통과회고성분석비교구연산납여간소항응재CRRT 치료중적응용。방법납입54례환자，수궤분위량조，분별접수구연산납，저분자간소예충CRRT，동보항응，비교응혈지표、전해질화산감평형이급려기관로수명。결과구연산염조혈액투석기사용시간명현장우저분자간소조。구연산염조재혈액투석중APTT、PT여저분자간소조비교，차이균유통계학의의（ P＜0．05），응용구연산납국부항응후혈려관도내혈액적응혈지표（APTT、PT）연장，경과려기후응혈지표변화불대（P＞0．05），체내정맥혈응혈지표회복정상범위내；저분자간소조려기전후관도중응혈지표변화불대（P＞0．05），여구연산납조비교，저분자간소조재체내적（ APTT、PT）균연장。결론구연산납항응방식안전유효，괄우추엄。재투석과정중밀절관찰，의거동맥혈기，전해질결과조정구연산납제량，사매차혈액려과치료순리유효지진행，시치료성공적보장。
Objective To compare the application of sodium citrate and heparin in the treatment of CRRT through a retrospective analysis .Methods A total of 53 patients were randomly divided into two groups , patients in the two groups were treated with sodium citrate and low molecular weight heparin for CRRT pre -wash. We comparred the coagulation ,electrolyte, acid-base balance and the life of the filter pipeline of the two groups . Results The life of filter of citrate hemodialysis group was significantly longer than low molecular weight heparin group.The differences of APTT and TT between the two groups was statistically significant (P<0.05).Sodium citrate was precede heparin in anticoagulant effect for it's stable electrolyte and acid -base balance .Conclusions Anticoagulation of sodium citrate is safe and effective , suitable for promotion .Closely observe during dialysis and adjust the dose of sodium citrate according to arterial blood gas and electrolyte can ensure the successful treatment.