中国医学创新2016，Vol.13Issue(27)：120-122,123,4.DOI:10.3969/j.issn.1674-4985.2016.27.032
RCA-HD时外周血钙检测的一种替代方式的探索
Exploration of A Way to Replace Peripheral Blood Calcium Detection During RCA-HD
薛迎风 1赵素霞 2于振国 1郝江春 2郭磊 2何宜娇2
作者信息
- 1. 广东省深圳市南山区西丽人民医院 广东 深圳 518055
- 2. 河北中医学院附属京东誉美中西医结合肾病医院
- 折叠
摘要
Abstract
Objective:To explore the relationship between different ionized calcium(iCa) concentrations in arterial line and peripheral vein of regional citrate anticoagulation hemodialysis(RCA-HD) for application. Method:From October 2014 to February 2016,46 cases of acute or chronic renal failure patients in our hospital were selected.4% sodium citrate was infused into the arterial line before dialyzer,calcium bicarbonate dialysate (1.75 mmol/L),hollow fiber dialyzer and low calcium points arrangement in filling calcium.The additional calcium supplementation was administered in the way of echelon according to pre-HD blood iCa level.Blood sample was collected from the arterial line before the infusion of citrate and from the peripheral vein.The data of the two groups were analyzed to observe the difference between iCa concentration levels in the arterial line and in peripheral vein,the anticoagulant effect of RCA and possible complications,such as bleeding and hypocalcaemia. Result:Among 46 cases of acute and chronic renal failure patients with active bleeding and high risk of bleeding tendency,51 times of RCA-HD performed.Statistics showed that,arterial line and peripheral compared difference was statistically significant(P<0.05),regression testr=0.924,there was correlation between the two sets of data.The regression equation:PiCa=0.11 + 0.908×A tube of iCa,r=0.935.None induced bleeding,or bleeding aggravated,blood calcium concentration was controlled in the ideal range.Conclusion:In clinical practice,the value of arterial line iCa concentration can be used to replace the value of iCa concentration in peripheral blood. RCA-HD therapy is safe and effective.Calcium supplementation in the way of echelon is recommended expanding.关键词
枸橼酸局部抗凝血液透析/游离钙/动脉管路/外周静脉/梯次/补钙Key words
RCA-HD/Ionized calcium/Arterial line/Peripheral vein/Echelon/Calcium supplementation引用本文复制引用
薛迎风,赵素霞,于振国,郝江春,郭磊,何宜娇..RCA-HD时外周血钙检测的一种替代方式的探索[J].中国医学创新,2016,13(27):120-122,123,4.
