[1]李杨昊.不同抗凝方式在连续性肾脏替代治疗急性肾损伤患者中的疗效及安全性比较[J].医学信息,2022,35(16):121-124.[doi:10.3969/j.issn.1006-1959.2022.16.030]
　LI Yang-hao.Comparison of Efficacy and Safety of Different Anticoagulant Methods in Continuous Renal Replacement Therapy for Acute Kidney Injury[J].Journal of Medical Information,2022,35(16):121-124.[doi:10.3969/j.issn.1006-1959.2022.16.030]
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不同抗凝方式在连续性肾脏替代治疗急性肾损伤患者中的疗效及安全性比较()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年16期
页码:
121-124
栏目:
临床研究
出版日期:
2022-08-15

文章信息/Info

Title:
Comparison of Efficacy and Safety of Different Anticoagulant Methods in Continuous Renal Replacement Therapy for Acute Kidney Injury
文章编号:
1006-1959（2022）16-0121-04
作者:
李杨昊
（天津市职业病防治院ICU，天津 300011）
Author(s):
LI Yang-hao
(ICU of Tianjin Occupational Disease Prevention and Control Hospital,Tianjin 300011,China)
关键词:
连续性肾脏替代; 急性肾损伤; 抗凝效果
Keywords:
Continuous renal replacement; Acute kidney injury; Anticoagulant effect
分类号:
R692.5
DOI:
10.3969/j.issn.1006-1959.2022.16.030
文献标志码:
A
摘要:
目的 比较不同抗凝方式在连续性肾脏替代治疗急性肾损伤患者中的疗效及安全性。方法 选取2016年4月-2021年4月我院治疗的47例行连续肾脏替代治疗的急性肾损伤患者为研究对象，采用随机数字表法分为对照组（n=23）和观察组（n=24）。对照组采用肝素钠治疗，观察组采用阿加曲班治疗。比较两组凝血功能指标（Hb、PLT、APTT）、抗凝效果、穿刺点压迫止血时间、电解质及酸碱平衡指标（pH、Na+、HCO3-）以及并发症发生率。结果 两组治疗后Hb、PLT低于治疗前，APTT高于治疗前，且观察组Hb、PLT高于对照组，APTT低于对照组（P＜0.05）；观察组抗凝分级0级、Ⅰ级比例大于对照组，Ⅱ级、Ⅲ级比例小于对照组（P＜0.05）；观察组穿刺点止血时间短于对照组（P＜0.05）；观察组治疗后HCO3-低于对照组，总钙高于对照组（P＜0.05），而两组pH、Na+比较，差异无统计学意义（P＞0.05）；观察组并发症发生率为8.33%，低于对照组的21.74%（P＜0.05）。结论 阿加曲班在连续性肾脏替代治疗急性肾损伤患者中的抗凝效果良好，可改善凝血功能指标，预防血小板减少症，纠正水电解质平衡，缩短穿刺点压迫止血时间，降低并发症发生率，是一种安全、有效的治疗药物。
Abstract:
Objective To compare the efficacy and safety of different anticoagulation methods in continuous renal replacement therapy for acute kidney injury.Methods A total of 47 patients with acute kidney injury who underwent continuous renal replacement therapy in our hospital from April 2016 to April 2021 were selected as the research objects. They were divided into control group (n=23) and observation group (n=24) by random number table method. The control group was treated with heparin sodium, and the observation group was treated with argatroban. The coagulation function indexes (Hb, PLT, APTT), anticoagulant effect, hemostasis time of puncture point compression, electrolyte and acid-base balance indexes (pH, Na+, HCO3-) and the incidence of complications were compared between the two groups.Results After treatment, Hb and PLT in the two groups were lower than those before treatment, APTT was higher than that before treatment, Hb and PLT in the observation group were higher than those in the control group, APTT was lower than that in the control group (P<0.05). The proportion of anticoagulation grade 0 and grade Ⅰ in the observation group was higher than that in the control group, and the proportion of grade Ⅱ and grade Ⅲ was lower than that in the control group (P<0.05). The hemostasis time of puncture point in the observation group was shorter than that in the control group (P<0.05). After treatment, HCO3- in the observation group was lower than that in the control group, and the total calcium was higher than that in the control group (P<0.05); there was no significant difference in pH and Na+ between the two groups (P>0.05). The incidence of complications in the observation group was 8.33%, which was lower than 21.74% in the control group (P<0.05).Conclusion There are differences in the efficacy of different anticoagulation methods in patients with acute renal injury after continuous renal replacement therapy (CRRT).Compared with CRRT, CRRT has a good Argatroban effect in improving coagulation function and preventing thrombocytopenia, it is a safe and effective drug to correct the balance of water and electrolyte, shorten the time of hemostasis and reduce the incidence of complications.

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更新日期/Last Update: 1900-01-01