国际医药卫生导报2025，Vol.31Issue(9)：1516-1520,5.DOI:10.3760/cma.j.cn441417-20240828-09021
局部枸橼酸钠联合小剂量肝素钠抗凝在脓毒症并急性肾损伤患者CRRT中的应用价值
The application value of topical sodium citrate combined with low-dose heparin sodium anticoagulation in CRRT for patients with sepsis and acute kidney injury
摘要
Abstract
Objective To explore the application value of topical sodium citrate combined with low-dose heparin sodium anticoagulation in the treatment of continuous blood purification(CRRT)in patients with sepsis and acute kidney injury.Methods This research is a randomized controlled trial.Seventy-one patients with sepsis and acute kidney injury(AKI)who were admitted to Shangxian Central Hospital from January 2021 to January 2024 were selected as the research subjects.The patients were divided into the control group(35 cases)and the treatment group(36 cases)by using the random number table method.There were 18 males and 17 females in the control group,aged(53.40±12.03)years.There were 18 males and 18 females in the treatment group,aged(57.97±10.66)years.The control group was treated with CRRT under topical sodium citrate,and the treatment group was treated with CRRT under topical sodium citrate combined with low-dose heparin sodium anticoagulation.Compare the transmembrane pressure(TMP),pressure drop(PFU)and platelet count(PLT)of the two groups before and after treatment at 12 h,24 h and 48 h;the coagulation grade of the filter and venous reservoir at 24 h after treatment;and the bleeding conditions(skin and mucous membranes,digestive tract,urinary tract,etc.).Independent sample t test,paired t test,x2 test,fisher exact probability and rank sum test were used for statistical analysis.Results At 12 h,24 h and 48 h after treatment,the TMP of the treatment group were lower than those of the control group[(114.97±22.65)mmHg(1 mmHg=0.133 kPa)vs.(126.91±22.88)mmHg,(133.28±20.04)mmHg vs.(143.17±20.30)mmHg,(151.14±17.43)mmHg vs.(159.80±17.68)mmHg](all P＜0.05);and the PFU were lower than those of the control group[(97.58±15.22)mmHg vs.(105.71±15.85)mmHg,(118.81±13.72)mmHg vs.(126.51±13.25)mmHg,(140.39±14.19)mmHg vs.(147.43±12.02)mmHg](all P＜0.05);there were no statistically significant difference in the PLT between the two groups(all P＞0.05).At 24 hours after treatment,the coagulation grades of the filters and venous reservoirs of the treatment group were better than those of the control group(P＜0.05).There was no statistically significant difference in the total incidence of bleeding between the two groups(P＞0.05).Conclusion The treatment of CRRT under topical sodium citrate combined with low-dose heparin sodium anticoagulation can extend the service life of the filter,improve the efficiency of the filter in removing inflammatory mediators,and the therapeutic effect is good without increasing the treatment risk.关键词
枸橼酸钠/抗凝/脓毒症/急性肾损伤/血液净化Key words
Sodium citrate/Anticoagulation/Sepsis/Acute kidney injury/Blood purification引用本文复制引用
张珂,刘景刚,吴瑞荣,冯慧..局部枸橼酸钠联合小剂量肝素钠抗凝在脓毒症并急性肾损伤患者CRRT中的应用价值[J].国际医药卫生导报,2025,31(9):1516-1520,5.基金项目
山东省医药卫生科技项目(202319010123) Shandong Province Medical and Health Science and Technology Project(202319010123) （202319010123）
