论文部分内容阅读
目的 :探讨高危出血合并肾功能衰竭患者在血液透析时 ,如何使用局部枸橼酸抗凝 (RCA)来完成血液透析及其疗效。方法 :采用 1.8%浓度的枸橼酸钠、空心纤维透析器和普通含碳酸氢盐透析液 ,观察 RCA透析对患者出血、体外循环凝血、血游离钙 (Ca2 + )、p H、HCO- 3、Scr、BU N、HR的影响 ,同时设无肝素透析组及普通肝素透析组对照 ,观察透析效果、体外循环凝血时间 (CT)及体内血 CT、透析器复用时间的变化。结果 :2 6例急、慢性肾衰患者共行 79例次RCA透析 ,未见有引起或加重出血者。透析器及管路未见发生严重凝血现象 ,无明显电解质、酸碱平衡紊乱症状 ,透析效果优于无肝素治疗组 ,与普通肝素治疗组无显著性差异。结论 :低浓度 RCA透析安全、有效、简便 ,适用于高危出血患者。
Objective: To explore how to use local citrate anticoagulation (RCA) to hemodialysis and its effect in hemodialysis patients with high-risk bleeding and renal failure. Methods: The effects of RCA dialysis on hemorrhage, extracorporeal coagulation, calcium (Ca2 +), p H and HCO-3 in patients with 1.8% sodium citrate, hollow fiber dialyzers and ordinary bicarbonate dialysate were observed. , Scr, BU N and HR. At the same time, hemodialysis group and unfractionated heparin dialysis group were set up to compare the effects of dialysis, CT and CT, dialyzer recycle time. RESULTS: Twenty-six patients with acute and chronic renal failure had a total of 79 RCA dialysis sessions. No bleeding or bleeding was found. Serious coagulation of the dialyzer and tubing was not observed, no obvious electrolyte, acid-base balance disorders, dialysis effect was better than the non-heparin treatment group, and unfractionated heparin treatment group no significant difference. Conclusions: Low-density RCA dialysis is safe, effective and simple and suitable for patients with high-risk bleeding.