ObjectiveTo observe and analyze application of regional citrate combined with low molecular weight heparin calcium anticoagulation in continuous renal replacement treatment.MethodsA totalof 50 critical patients with continuous renal replacement treatment were randomly divided into research group and control group, with 25 cases in each group. The control group received low molecular heparin anticoagulation, and the research group received regional citrate combined with low molecular weight heparin calcium anticoagulation. Application effect was observed and compared.ResultsThe research group had 0 bleeding or aggravation of original bleeding, which was less than 6 cases (24.00%) in control group, and the difference had statistical significance(P<0.05). The research group had 2 cases (8.00%) of anticoagulation effects as 0~Ⅰ grade, 0 case of Ⅱ~Ⅲ grade, and the control group was respectively as 8 cases (32.00%) and 4 cases (16.00%), and the difference had statistical significance (P<0.05). There were no statistically significant difference in biochemical indexes, pH value and Na+ before and after dialysis between two groups (P>0.05). Both groups had lower urea nitrogen (BUN) and serum creatinine (Scr) level after dialysis than before dialysis, the research group had higher bicarbonate radical than control group and lower total calcium than control group, and the difference had statistical significance (P<0.05).ConclusionRegional citrate combined with low molecular weight heparin calcium anticoagulation shows perfect effect in continuous renal replacement treatment. This method is also safe and reliable with and practical promotion value.%目的：针对局部枸橼酸联合小剂量低分子肝素抗凝在连续性肾脏替代治疗中的应用情况实施观察及分析。方法50例需展开连续性肾脏替代治疗的危重患者,随机分成研究组和参照组,各25例。参照组仅予以低分子肝素抗凝方案,研究组实施局部枸橼酸联合小剂量低分子肝素抗凝方案,观察并对比应用效果。结果研究组中出血或原有出血加重情况为0例(0),少于参照组的6例(24.00%),差异有统计学意义(P<0.05)；同时研究组抗凝效果为0~Ⅰ级为2例(8.00%),Ⅱ~Ⅲ级为0例(0),参照组分别为8例(32.00%)、4例(16.00%),两组比较差异有统计学意义(P<0.05)。两组的生化指标比较,透析前后的pH值以及Na+对比,差异无统计学意义(P>0.05)；透析后的尿素氮(BUN)以及血肌酐(Scr)水平均明显低于透析前,并且研究组HCO3-高于参照组,总钙低于参照组,差异有统计学意义(P<0.05)。结论采取局部枸橼酸联合小剂量低分子肝素抗凝举措在连续性肾脏替代治疗中的效果较为理想,安全可靠,具备推广实践的价值。
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