CAJ | 학술논문

目的：通过研究局部枸橼酸抗凝用于连续性静脉静脉血液滤过（ CVVH）治疗，来寻找一种安全有效简便的抗凝方法。方法选择重症医学科患者10例，用局部枸橼酸抗凝共行CVVH治疗35例次，监测患者治疗前后及治疗中全血活化凝血时间（ ACT）、血清钠及碳酸氢根变化。结果治疗中体外ACT时间较治疗前延长（169．3±12．6 vs 107．6±16．7 s，P＜0．05），差异有统计学意义；血钠（141．2±6．7 vs 135．8±7．5 mmol／L，P＞0．05）、碳酸氢根浓度（25．2±3．1 vs 22．4±5．1 mmol／L，P＞0．05）治疗后较治疗前差异无统计学意义。结论应用局部枸橼酸抗凝技术行CVVH治疗对系统凝血功能无影响，无明显副作用。用局部枸橼酸抗凝行CVVH治疗时简单并且安全。
목적：통과연구국부구연산항응용우련속성정맥정맥혈액려과（ CVVH）치료，래심조일충안전유효간편적항응방법。방법선택중증의학과환자10례，용국부구연산항응공행CVVH치료35례차，감측환자치료전후급치료중전혈활화응혈시간（ ACT）、혈청납급탄산경근변화。결과치료중체외ACT시간교치료전연장（169．3±12．6 vs 107．6±16．7 s，P＜0．05），차이유통계학의의；혈납（141．2±6．7 vs 135．8±7．5 mmol／L，P＞0．05）、탄산경근농도（25．2±3．1 vs 22．4±5．1 mmol／L，P＞0．05）치료후교치료전차이무통계학의의。결론응용국부구연산항응기술행CVVH치료대계통응혈공능무영향，무명현부작용。용국부구연산항응행CVVH치료시간단병차안전。
Objective To investigate the application of regional citrate anticoagulation for continuous venovenous hemofiltration ( CVVH) in order to find a safe effective and simple anticoagulation method. Methods A total of 10 patients in department of critic care medicine were treated with 35 blood purification sessions in regional citrate anticoagulation. The Activated coagulation time ( ACT ) and the serum sodium and bicarbonate were measured pre-treatment, in the treatment and post-treatment.Results The ACT in the treatment was significantly increased from pre-treatment (169.3 ±12.6 vs 107.6 ±16.7 s, P<0.05).There was no statistical difference observed between post-and pre-treatment regarding the serum sodium (141.2 ±6.7 vs 135.8 ±7.5 mmol/l, P>0.05) and bicarbonate (25.2 ±3.1 vs 22.4 ±5.1 mmol/l, P >0.05).Conclusions The application of regional citrate anticoagulation of CVVH shows that the systemic anticoagulation does not occur and complications are not found. Using regional citrate anticoagulation during CVVH is simple and safe for patients.