CAJ | 학술논문

目的：改良目前血液净化枸橼酸抗凝方案，减少灌流过程中堵管发生率及血红蛋白、血小板等减少，以及血液灌流对全身凝血机制的影响，研究其应用可行性。方法纳入初次行血液灌流病例随机进行目前通用血液灌流方案或改良后血液灌流方案，对照其灌流过程中灌流器及管路凝血情况及灌流前后患者血红蛋白、血小板、凝血时间、活化的部分凝血活酶时间、谷丙转氨酶、谷草转氨酶、白蛋白、尿素氮、肌酐变化情况。结果与对照组相比较改良后枸橼酸抗凝方案堵管发生率变化不明显，但其导致的血小板、血红蛋白减少，凝血时间及活化的部分凝活酶血时间延长等情况差异具有显著性。结论改良枸橼酸抗凝治疗方案，操作简便，对体内各相关指标影响较小，适宜临床应用。
목적：개량목전혈액정화구연산항응방안，감소관류과정중도관발생솔급혈홍단백、혈소판등감소，이급혈액관류대전신응혈궤제적영향，연구기응용가행성。방법납입초차행혈액관류병례수궤진행목전통용혈액관류방안혹개량후혈액관류방안，대조기관류과정중관류기급관로응혈정황급관류전후환자혈홍단백、혈소판、응혈시간、활화적부분응혈활매시간、곡병전안매、곡초전안매、백단백、뇨소담、기항변화정황。결과여대조조상비교개량후구연산항응방안도관발생솔변화불명현，단기도치적혈소판、혈홍단백감소，응혈시간급활화적부분응활매혈시간연장등정황차이구유현저성。결론개량구연산항응치료방안，조작간편，대체내각상관지표영향교소，괄의림상응용。
Objective To improve the current blood purification plan of improving regional citrate anticoagulation ,reduce the plugging occurrence rate and avoid hemoglobin and blood platelet decrease in the perfusion process ,and lower blood perfusion's influence on the whole body's clotting mechanism ,study the feasibility of its application .Methods Randomly conduct the cur‐rently common or improved blood perfusion proposal in the cases of initial blood perfusion ;in the perfusion process ,compare situations of hemoperfusion and pipeline coagulation ,and variation conditions of patients'hemoglobin ,blood platelet ,blood clot‐ting time ,activated partial thromboplastin time ,glutamic‐pyruvic transaminase ,glutamic oxalacetic transaminase ,albumin ,urea nitrogen and creatinine before and after the perfusion .Results Compared to the control group ,the improved plan of improving regional citrate anticoagulation plugging occurrence rate does not pose an obvious difference ,but in conditions which it leads to , such as decrease of blood platelet and hemoglobin and extended time of coagulation and activated partial thromboplastin ,there is a significant difference .Conclusion The improved treatment plan of regional citrate anticoagulation is easy to operate and has less impact on all the relevant internal indicators .It is suitable for clinical use .