不同抗凝方式下连续组静脉-静脉血液滤过透析治疗对凝血及透析滤器使用寿命的影响研究

摘要

目的 观察低分子肝素全身抗凝和枸橼酸局部抗凝在连续性静脉-静脉血液滤过透析(CVVH)时滤器使用寿命的比较研究.方法 回顾性分析2016年1-4月54例患者行128例次CVVH的治疗情况,按照抗凝方式不同分为枸橼酸钠组和低分子肝素组,对两组患者的临床资料、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、滤器使用时间及疗效进行比较.结果 两种抗凝方式下均取得显著疗效,枸橼酸钠组滤器及管路平均使用寿命显著长于低分子肝素组.结论 枸橼酸局部抗凝技术在延长滤器使用时间方面有明显优势,且对患者凝血指标影响较小.%Objective To observe and compare the treatment filter service life lifetime of continuous venous-venous hemofiltration (CVVH) by means of low molecular weight heparin with systemic anticoagulation and citrate local anticoagulation.Methods A retrospective analysis methods was used to study the treatment of 128 patients with 54 secondary CVVH from January 2016to April 2016.Patients were divided into sodium citrate group and low molecular heparin group according to different anticoagulant methods.The clinical data, activated partial thromboplastin time (APTT), prothrombin time (PT), filter time and curative effect for two group of patients was observed and compared.Results Both groups had achieved remarkable treatment effects, the average life span of the sodium citrate filter and pipeline was significantly longer than that of the low-molecular-weight Heparin group.Conclusion Regional citrate anticoagulation has an obvious advantages in prolong the life time of the filter,and has less influence on patients' coagulation indexes.