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目的 探讨和研究枸橼酸与普通肝素抗凝在肾移植术后肾功能延迟恢复(DGF)患者的连续肾脏替代疗法(CRRT)中的应用效果及安全性对比。方法研究对象选取为2012年1月—2015年1月之间行肾移植术后出现DGF的36例患者,采用随机数字表法分为观察组和对照组各18例,两组患者均行CRRT治疗,对照组采用普通肝素抗凝,观察组则采用枸橼酸抗凝,对两组患者的血液净化效果和不良反应进行统计对比。结果 两组患者在平均血流速度、24 h置换液量、透析器使用时间对比上差异无统计学意义(P>0.05);观察组患者无一例发生相关不良反应,不良反应发生率0.0%,对照组出现牙龈出血2例,消化道出血3例,全身皮下瘀斑2例,不良反应发生率38.9%,观察组显著低于对照组(P<0.05)。结论 DGF患者在行CRRT治疗过程中,应用枸橼酸抗凝的效果较好,且安全性显著高于普通肝素,值得在临床上推广和应用。
Objective To investigate and study the effect and safety of citrate and unfractionated heparin anticoagulation in the treatment of continuous renal replacement therapy (CRRT) in patients with delayed renal failure (DGF) after renal transplantation. Methods Thirty-six patients with DGF after renal transplantation between January 2012 and January 2015 were randomly divided into observation group (18 cases) and control group (18 cases). CRRT Treatment, the control group with unfractionated heparin anticoagulation, the observation group was the use of citric acid anticoagulation, the two groups of patients with blood purification and adverse reactions statistical comparison. Results There was no significant difference between the two groups in mean blood flow velocity, 24 h replacement fluid volume and dialyzer use time (P> 0.05). No adverse reactions were observed in the observation group and the incidence of adverse reactions was 0.0% In the control group, 2 cases of gingival bleeding, 3 cases of gastrointestinal bleeding, 2 cases of systemic subcutaneous ecchymosis, the incidence of adverse reactions 38.9%, the observation group was significantly lower than the control group (P <0.05). Conclusion In patients with DGF, the anticoagulation effect of citrate is better and the safety is higher than that of unfractionated heparin in the treatment of CRRT. It is worth to be popularized and applied clinically.