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On-line Access: 2022-11-15
Received: 2022-02-17
Revision Accepted: 2022-06-19
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Citations: Bibtex RefMan EndNote GB/T7714
Xiaoyan TANG, Dezheng CHEN, Ling ZHANG, Ping FU, Yanxia CHEN, Zhou XIAO, Xiangcheng XIAO, Weisheng PENG, Li CHENG, Yanmin ZHANG, Hongbo LI, Kehui LI, Bizhen GOU, Xin WU, Qian YU, Lijun JIAN, Zaizhi ZHU, Yu WEN, Cheng LIU, Hen XUE, Hongyu ZHANG, Xin HE, Bin YAN, Liping ZHONG, Bin HUANG, Mingying MAO. Application of regional citrate anticoagulation in patients at high risk of bleeding during intermittent hemodialysis: a prospective multicenter randomized controlled trial[J]. Journal of Zhejiang University Science B,in press.Frontiers of Information Technology & Electronic Engineering,in press.https://doi.org/10.1631/jzus.B2200082 @article{title="Application of regional citrate anticoagulation in patients at high risk of bleeding during intermittent hemodialysis: a prospective multicenter randomized controlled trial", %0 Journal Article TY - JOUR
局部枸橼酸钠抗凝在出血高危患者间歇性血液透析中的临床应用--一项前瞻性多中心随机对照研究1四川大学华西医院肾脏研究所,中国成都市,610041 2四川省简阳市人民医院肾内科,中国成都市,641400 3南昌大学第二附属医院肾内科,中国南昌市,330006 4中南大学湘雅医院肾内科,中国长沙市,410008 5武汉市第一医院肾内科,中国武汉市,430022 6广西医科大学第一附属医院血液净化部,中国南宁市,530021 7贵阳市第一人民医院肾内科,中国贵阳市,550002 8四川大学华西医院金堂医院肾内科,中国金堂县,610400 9眉山市人民医院肾内科,中国眉山市,620020 10资阳市人民医院肾内科,中国资阳市,641300 11雅安市人民医院肾内科,中国雅安市,625000 12成都康福肾脏病医院肾内科,中国成都市,610047 13凉山彝族自治州第一人民医院肾内科,中国西昌市,615000 目的:安全有效的抗凝治疗对于高危出血风险的血液透析患者至关重要。本试验的目的是评估应用标准含钙透析液进行双段法局部枸橼酸(RCA)联合序贯抗凝在间歇性血液透析(IHD)治疗中的有效性和安全性。 方法:前瞻性纳入13个肾内科血液净化中心2019年9月至2021年5月行IHD的出血高危患者,随机分为RCA组和生理盐水冲洗组。RCA组使用0.04 g/mL枸橼酸钠分别从透析管路的引血端及静脉壶双段输注,透析3小时后停用枸橼酸钠,并改为无抗凝剂模式序贯透析。根据基线计算凝血风险比。 结果:共纳入159名患者208例次,包括RCA组(80名,110例次)和盐水冲洗组(79名,98例次)。RCA组体外循环管路严重凝血事件的发生率明显低于生理盐水冲洗组(3.64% vs. 20.41%,P<0.001)。RCA组滤器管路的生存时间较生理盐水冲洗组明显延长((238.34±9.33) min和(221.73±34.10) min,P<0.001)。RCA组的尿素清除指数(Kt/V)与生理盐水冲洗组相当,差异无统计学意义(1.12±0.34 vs. 1.08±0.34,P=0.41)。 结论:与生理盐水冲洗相比较,双段法枸橼酸联合序贯抗凝能显著减少体外循环凝血事件,延长透析时间,且未观察到严重不良事件发生。 关键词组: Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article
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