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区域酸盐抗凝剂与没有抗凝剂对CKRT在肝功能衰竭患者有增加的出血风险的患者
Ming Bai1, Yan Yu1, Lijuan Zhao1
1The Department of Nephrology, Xijing Hospital, the Fourth Military Medical University, Xi'an, China.
Clinical journal of the American Society of Nephrology : CJASN
|November 22, 2023
概括
区域酸盐抗凝剂 (RCA) 用于肝衰竭患者的连续脏替代疗法 (CKRT) 显著延长了过器的寿命,但增加了低血症的风险. 没有抗凝剂导致过器故障率更高.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 肝病学 肝病学是一种肝病学.
- 关键护理医学 关键护理医学
背景情况:
- 持续置换疗法 (CKRT) 对严重肝衰竭患者至关重要.
- 在这个高出血风险群体中,CKRT的抗凝血策略仍在讨论中.
- 区域酸盐抗凝药 (RCA) 是一种替代不使用抗凝药的药物.
研究的目的:
- 在肝衰竭和高出血风险的患者中,比较RCA与CKRT没有抗凝药的疗效和安全性.
- 评估过器故障率和两个组的不良事件.
主要方法:
- 进行了一项随机对照试验.
- 招募了患有肝衰竭和高出血风险,需要CKRT的成年患者.
- 参与者被随机分配,接受RCA或不接受CKRT的抗凝药.
主要成果:
- 没有抗凝剂的组表现出明显更高的过器故障率 (56%对27%).
- 区域性酸盐抗凝剂与低血症 (82%) 的发病率增加和Ca2+tot/Ca2+离子比率升高 (57%) 相关.
- 在RCA组中,大多数代谢障碍是可以通过替代物来控制的.
结论:
- 区域酸盐抗凝药可显著延长过器寿命,肝衰竭患者接受CKRT,与没有抗凝药相比.
- 然而,RCA与此种人群中低血症和电解质障碍的风险较高有关.
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