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连续性肾脏替代治疗已成为儿童肝衰竭患者的重要器官支持手段。抗凝是决定该治疗手段成功与否的关键步骤。传统的全身肝素抗凝有诱发血小板减少，引起出血的高风险；鱼精蛋白拮抗肝素局部抗凝临床效果不佳；无肝素抗凝在儿童患者尤其低体重小婴儿中很难顺利开展。近年来局部枸橼酸抗凝作为一种新型抗凝方式逐渐受到重视。本文针对这一抗凝技术的临床应用进行综述。“,”Continuous renal replacement therapy has become an important organ support method for children with liver failure.Anticoagulation is a key step in determining the success of this treatment.Traditional systemic heparin anticoagulation has a high risk of inducing thrombocytopenia and bleeding.Protamine antagonistic heparin local anticoagulation performance is unsatisfactory.Anticoagulation without heparin is difficult to develop smoothly in children, especially low-weight infants.In recent years, regional citrate anticoagulation has gradually received attention as a new type of anticoagulation.This article reviewed the clinical application of this anticoagulation technology.