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目的 研究局部枸橼酸抗凝的静脉-静脉血液透析(regional citrate anticoagulation continuous venous-venous hemodialysis,RCA-CVVHD)在心血管外科术后急性肝肾损伤患者中的应用.方法 回顾性分析中国医科大学附属第一医院心血管外科2014年1～12月术后急性肾损伤应用RCA-CVVHD同时合并急性肝损伤10例患者的临床资料,其中男5例、女5例,年龄35 ～ 69 (58.2±12.7)岁.监测患者在床旁透析开始治疗前、治疗后12h、24h、48 h、72h的pH值、游离钙(iCa)、钠离子(Na+)、碱剩余(BE)、总钙tCa与iCa比值(tCa/iCa).结果 pH值(7.47±0.12 vs.7.50±0.06vs.7.48±0.04 vs.7.48±0.03 vs.7.45±0.05,P＞0.05)及BE值[(0.91±9.97) mmol/Lvs.(2.36±3.92) mmol/L vs.(-0.22±3.09) mmol/L vs.(1.87±3.58) mmol/L vs.(-1.05±1.12) mmol/L,P＞0.05)]治疗前后差异无统计学意义;iCa[(1.09±0.09) mmol/L vs.(1.15±0.08) mmol/L vs.(1.17±0.08) mmol/L vs.(1.24±0.09) mmol/Lvs.(1.16±0.06)mmol/L]、Na+[(149.44±6.84)mmol/L vs.(144.33±3.35)mmol/L vs.(143.13±3.52)mmol/Lvs.(141.25±5.52) mmol/L vs.(136.71±4.92) mmol/L]、tCa/iCa (2.07±0.11 vs.2.10±1.12 vs.2.17±0.69 vs.2.23±1.05 vs.2.30±0.11)差异有统计学意义.结论 RCA-CVVHD在心血管外科术后急性肾损伤合并急性肝损伤患者中的使用安全、可行.“,”Objective To investigate the effects and feasibility of regional citrate anticoagulation continuous venous-venous hemodialysis(RCA-CVVHD) in acute hepatic & kidney injury after cardiovascular surgery.Methods Ten patients with acute kidney injury combined with acute hepatic injury after cardiovascular surgery were involved in this study.There were 5 males and 5 females at age of 35-69(58.2± 12.7) years.All of them were treated by RCA-CVVHD.Blood samples were collected before treatment,12 h,24 h,48 h,and 72 h after treatment.Results There was no statistical difference between post-and pre-treatment regarding with pH value (7.47±0.12 vs.7.50±0.06 vs.7.48±0.04 vs.7.48±0.03 vs.7.45±0.05,P＞0.05) or BE value (0.91±9.97 mmol/L vs.2.36±3.92 mmol/L vs.-0.22±3.09 mmol/L vs.1.87±3.58 mmol/L vs.-1.05± 1.12 mmol/L,P＞0.05).There was a statistical difference in iCa (1.09±0.09 mmol/L vs.1.15±0.08 mmol/L vs.1.17±0.08 mmol/L vs.1.24±0.09 mmol/L vs.1.16±0.06 mmol/L),Na+ (149.44±6.84 mmol/L vs.144.33±3.35 mmol/L vs.143.13±3.52 mmol/L vs.141.25±5.52 mmol/L vs.136.71±4.92 mmol/L),and tCa/iCa (2.07±0.11 vs.2.10±1.12 vs.2.17±0.69 vs.2.23±1.05 vs.2.30±0.11),respectively.Conclusion RCA-CVVHD used in patients with acute hepatic impairment is safe and feasible.