改良局部枸橼酸抗凝在儿童血液滤过的应用

发布时间：2019-01-28 20:10

【摘要】：目的探讨透析泵泵注枸橼酸在儿童局部枸橼酸抗凝(RCA)连续性血液滤过(CHF)中的应用。方法回顾性分析2015年9月至2017年1月重庆医科大学附属儿童医院重症监护室49例行RCA-CHF治疗患儿的临床资料,分为传统组20例行RCA-CHF治疗;改良组29例(以透析泵泵注枸橼酸)在连续性血液透析滤过模式下行RCA-CHF治疗。观察输液泵气泡报警、采血不良、出凝血等不良事件,滤器寿命及枸橼酸抗凝常见并发症等发生情况。结果两组气泡报警、滤器寿命比较,差异有统计学意义(P0.05);两组治疗前后生化指标比较中,Na~+、iCa~(2+)、TCa~(2+)/iCa~(2+)及HCO_3~-比较,差异均有统计学意义(P0.05),但治疗前、后改良组与传统组Na~+、iCa~(2+)、TCa~(2+)/iCa~(2+)及HCO_3~-比较,差异均无统计学意义(P0.05)。结论透析泵代替枸橼酸泵的改良技术可以更安全有效地用于儿童RCA-CHF治疗。
[Abstract]:Objective to investigate the application of dialysate pump injection citric acid in children with local citrate anticoagulant (RCA) continuous hemofiltration (CHF). Methods the clinical data of 49 children treated with RCA-CHF in intensive care unit of children's hospital affiliated to Chongqing Medical University from September 2015 to January 2017 were analyzed retrospectively. The patients were divided into traditional group (n = 20) and RCA-CHF group (n = 20). 29 patients in the modified group were treated with continuous hemodiafiltration (RCA-CHF) under continuous hemodiafiltration mode. Bubble alarm, bad blood collection, coagulation, filter life and common complications of citric acid anticoagulant were observed. Results there was significant difference between the two groups in bubble alarm and filter life (P0.05). Na~, iCa~ (2), TCa~ (2) / iCa~ (2) and HCO_3~- were significantly different between the two groups before and after treatment (P0.05). There was no significant difference in TCa~ (2) / iCa~ (2) and HCO_3~- (P0.05). Conclusion the improved dialysate pump instead of citric acid pump can be used more safely and effectively in the treatment of RCA-CHF in children.
【作者单位】：重庆医科大学附属儿童医院重症医学科/儿童发育疾病研究教育部重点实验室/儿科学重庆市重点实验室/重庆市儿童发育重大疾病诊治与预防国际科技合作基地;
【基金】：百利儿科科研基金资助项目(B2016-A-3)
【分类号】：R720.597

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