枸橼酸钠用于心脏术后连续性血液净化治疗的效果及安全性

发布时间：2018-02-10 03:16

本文关键词： 枸橼酸钠抗凝治疗血液滤过　出处：《中国老年学杂志》2017年17期 　论文类型：期刊论文

【摘要】：目的探索在心脏大血管手术危重患者血液滤过中使用枸橼酸钠抗凝治疗的有效性及安全性。方法心胸外科行心脏大血管术后需持续静脉血液滤过患者100例,随机分为局部枸橼酸钠抗凝(RCA)组50例和低分子肝素组50例,分别给予枸橼酸钠和低分子肝素钙抗凝治疗,比较两组滤器使用时间,治疗前后血清Na~+、Ca~(2+)、实际HCO_3~-、血液pH值的变化及不良反应的发生次数。结果 RCA组滤器使用时间[(65.65±9.39)h]明显长于低分子肝素组[(59.31±9.28)h](P=0.018)。两组治疗前后血清Na~+、Ca~(2+)、实际HCO_3~-、血液pH值均无明显差异;RCA组未见不良反应。低分子肝素组出现伤口渗血1例,轻度血小板减少2例,轻微牙龈出血2例;但两组差异不显著(P0.05)。结论在连续性血液净化中RCA较传统低分子肝素抗凝能保证有效抗凝的同时延长滤器使用时间,减少患者费用,减少出血等不良事件发生。
[Abstract]:Objective to explore the efficacy and safety of sodium citrate anticoagulant in the treatment of hemofiltration in critically ill patients undergoing cardiac macrovascular surgery. Methods 100 patients with continuous venous hemofiltration after cardiac macrovascular operation were treated by cardiothoracic surgery. 50 cases of local sodium citrate anticoagulant group and 50 cases of low molecular weight heparin group were randomly divided into two groups: sodium citrate group and low molecular weight heparin calcium group. Before and after treatment, the serum Na ~ + Ca ~ (2 +), actual HCO _ 3 +, blood pH value and the occurrence times of adverse reactions were observed. Results the filter time of RCA group [65.65 卤9.39 h] was significantly longer than that of low-molecular-weight heparin group [59.31 卤9.28 h] P0.018. There was no significant difference between RCA group and low molecular weight heparin group, but there was no significant difference between RCA group and low molecular weight heparin group. There were 2 cases of mild thrombocytopenia and 2 cases of slight gingival bleeding, but the difference between the two groups was not significant (P 0.05). Conclusion in continuous blood purification, RCA can ensure the effective anticoagulant effect while prolonging the time of filter use and reducing the cost of the patients, compared with the traditional low-molecular-weight heparin anticoagulant. Reduce the occurrence of adverse events such as bleeding.
【作者单位】：徐州医科大学药学院;南京大学医学院附属鼓楼医院药学部;昭通市第一人民医院药剂科;南京大学医学院附属鼓楼医院心胸外科;
【基金】：江苏省药学会-奥赛康临床药学基金科研项目(No.201401)
【分类号】：R654.2;R692.5

【相似文献】