关键词: 低分子肝素, 枸椽酸, 抗凝, 连续性静脉血液滤过

Abstract: 【Abstract】 Objective〓To explore the clinical effect and nursing experience of citron acid anticoagulation in CVVH. Methods〓The total of 52 patients treated with CVVH were divided into two groups (Group A and Group B). The anticoagulation was selected citron acid in Group A (n=26) and low molecular weight heparin (LMWH) in Group B (n=26). The indexes of renal function, bleeding and coagulation, endurance of filter and pipelines and nurse working hours were recorded before and 72 hours after CVVH treatment in both groups. Results〓There was no significant difference of creatine 238.6±81.2 umol/l vs. 245.0±75.4 umol/l, t=1.664, P=0.130), urea nitrogen (13.8±4.8 vs. 13.5±5.2 umol/L, t=0.257, P=0.798) and APACHEII scores (17.7±3.4 vs. 16.0±4.1, t=1.608 P=0.114) in two groups. At the meantime, no significant difference was found in bleeding and coagulation (TT: 18.8±4.1 vs. 19.6±4.3Sec, t=-0.654、P=0.516,APTT:45.4±11.6 vs. 40.5±11.7Sec, t=1.498、P=0.140, PLT:108.9±49.7 vs. 113.2±48.4×109/L, t=-0.312、P=0.756 and bleeding from airway/puncture points (1 vs. 3 patients, Χ2=1.083,P=0.298) between two groups. But compared to Group B, the endurance of filter and pipelines (48.78±12.83 vs. 16.67±6.49 hours, t=-11.029,P=0) and nurse working hours (401.7±54.7 vs. 459.4±74.1min, t=3.195,P<0.05) were significantly different in Group A. Conclusion〓Citron acid anticoagulation was as safe and effective as LMWH anticoagulation in CVVH treatment but the former lowered nursing working load drastically.

Key words: Anticoagulation, Low molecular weight heparin, Continuous hemofiltration, Citron acid