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目的探讨低浓度枸橼酸钠抗凝在多发性复合伤合并急性肾损伤(AKI)患者进行连续床边血液滤过(CRRT)中的作用。方法对16例多发性复合伤合并AKI患者采用4%枸橼酸钠抗凝治疗(A组);另选取12例AKI患者作为对照组(B组),采用肝素抗凝治疗。观察两组体外循环凝血、血游离钙离子、pH值、碳酸氢根、血清肌酐(SCr)、血尿素氮(BUN)等水平。结果 A组未见有引起或加重出血,透析器及管路未发生严重凝血,无明显电解质、酸碱平衡紊乱,pH值、BUN、SCr、钙离子浓度等与B组无统计学差异(P>0.05)。结论 4%枸橼酸钠透析安全、有效、简便,适用于多发性复合伤合并AKI患者。
Objective To investigate the effect of low concentration sodium citrate anticoagulation on continuous bed hemofiltration (CRRT) in patients with multiple combined injury and acute kidney injury (AKI). Methods 16 cases of multiple combined injury and AKI were treated with 4% sodium citrate anticoagulation (group A). Another 12 cases of AKI were selected as control group (group B) and received heparin anticoagulation. The levels of blood coagulation, free calcium, pH, bicarbonate, serum creatinine (SCr) and blood urea nitrogen (BUN) in two groups were observed. Results No bleeding or dialysis occurred in group A, no serious coagulation of dialyzer and tubing, no obvious electrolyte, acid-base balance disorder, pH, BUN, SCr and calcium concentration were not significantly different from those in group B > 0.05). Conclusion 4% sodium citrate dialysis safe, effective and simple, suitable for multiple combined injury and AKI patients.