局部枸橼酸钠抗凝技术在ICU高出血风险患者中的应用

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Abstract Objective To explore the application value of local Sodium Citrate anticoagulation in patients with high bleeding risk in intensive care unit (ICU).Methods From March 2016 to May 2018,56 patients with high bleeding risk admitted to the ICU of the Third Medical Center of PLA General Hospital were selected as the research subjects.According to the random number table method,they were divided into the control group (n=28) and the observation group(n=28).In the control group,local Heparin Sodium anticoagulation was used,and in the observation group,local Sodium Citrate anticoagulation was adopted.The coagulation status of the dialyzer and tubing,and the changes in related laboratory indicators were compared between the two groups.The incidence of complications during treatment for all patients was recorded.Results In the control group,blood purification was performed in 189 times,and in the observation group,the purification was performed in 201 times.The incidence and severity of coagulation in the dialyzer and tubing in the observation group were lower than those in the control group,and the differences were statistically significant (P＜0.05).Before treatment,there were no statistically significant differences in the indexes of Ca2+,serum Na+,bicarbonate (HCO3-),activated partial thromboplastin time (APTT),urea nitrogen (BUN) and serum creatinine (SCr) between the two groups (P＞0.05).After treatment,both groups successfully completed blood purification treatment.The APTT of the observation group was shorter than that of the control group at 8 and 12 h after treatment,HCO3-was higher than that of the control group at 12 h after treatment,and the differences were statistically significant (P ＜0.05).There were no statistically significant differences in other above-mentioned indicators after treatment between the two groups (P＞0.05).The incidence rates of hemorrhage aggravated and new bleeding in the observation group were lower than those in the control group,and the differences were statistically significant (P＜0.05).Conclusion The application effect of local Sodium Citrate anticoagulation in blood purification treatment of patients with high bleeding risk in ICU is remarkable.It can effectively improve the coagulation indicators of ICU blood purification with high bleeding risk,reduce bleeding risk,and save medical expenses for patients.It is worthy of promotion.

Key words： Local Heparin Sodium anticoagulation Local Sodium Citrate anticoagulation ICU High bleeding risk Blood purification

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	Articles by authors
	YANG Si-ping
	ZHANG Jie
	ZHAO Bing-zhen

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YANG Si-ping,ZHANG Jie,ZHAO Bing-zhen. Application of local Sodium Citrate anticoagulation in patients with high bleeding risk in ICU[J]. 中国当代医药, 2020, 27(34): 16-20.

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2020/V27/I34/16

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