关键词: 枸橼酸钠, ICU, 脓毒血症, 连续性肾脏替代治疗

Abstract: 【Abstract】〓Objective〓To explore the changes of coagulations and properties of nursing care in septic patients treated with continuous renal replacement therapy (CRRT) using regional citrate anticoagulation (RCA) in the intensive care unit. Methods〓According to our including criteria, 76 patients were included in this retrospective analysis from March 2012 to June 2015. There were 40 patients using RCA (RCA group) and 36cases using low molecular weight heparin as anticoagulations (low molecular heparin group) in CRRT, respectively. Coagulation, arterial blood gas analysis, biochemistry, bleeding and endurance time of filters before and 3 days after treatments were compared between two groups. Results〓Although the serum levels of ureanitrogen (BUN), creatinine (Cr) and lactate (Lac) were significantly decreased in both groups (all p-values were less than 0.05), and no difference was detected between two groups. Notably,no significant changes of prothrombintime (PT), activated partial thromboplastin time (APTT) and platelets (PLT) were found in RCA group, while first two indicators were prolonged and the number of last indicator was decreased in low molecular weight heparin group(all p-values were less than 0.05). The ration of bleeding was significantly reduced and endurance time of filters was obviously increased in RCA group (all p-values were less than 0.05). Conclusion〓In our study, compared with management of low molecular heparin group usedduring CRRT, regional citrate anticoagulationexisted better clinical effects and less side-effects.

Key words: Regional citrate anticoagulation, Sepsis, Continuous renal replacement therapy