酸盐和低剂量肝素联合抗凝剂在儿科连续脏替代疗法中
Desheng Zhu1, Jie He1, Zhenghui Xiao1
1Pediatric Intensive Care Unit, The Affiliated Children's Hospital of Xiangya School of Medicine, Central South University (Hunan Children's Hospital), No. 86 Ziyuan Rd, Yuhua District, Changsha, 410007, Hunan, China.
Scientific reports
|June 12, 2024
概括
区域性酸盐抗凝剂与低剂量肝素相结合,可减少儿科连续脏替代疗法 (CRRT) 过器凝血,而不会增加出血风险.
科学领域:
- 儿科脏病学 儿科脏病学
- 关键护理医学 关键护理医学
- 血液学 血液学 血液学
背景情况:
- 在患有D-二次体升高的患者中,使用区域酸盐抗凝剂 (RCA) 进行儿科连续替代疗法 (CRRT) 的最佳抗凝剂尚不清楚.
- 过器凝血是影响CRRT疗效和患者结果的重大并发症.
研究的目的:
- 评估不同抗凝策略对CRRT过器寿命和患有D-二次体水平升高的儿科患者凝血风险的影响.
- 为了比较与联合RCA和全身肝素抗凝药与单独RCA相关的出血的发生率.
主要方法:
- 对接受CRRT的儿科患者的回顾性分析,按D-二次体水平和抗凝方案进行分类:仅RCA (正常的D-二次体),仅RCA (升高的D-二次体) 和RCA与全身肝素抗凝 (升高的D-二次体).
- 在研究组中比较过器寿命,过器凝血事件和出血发生率.
主要成果:
- RCA和低剂量全身肝素抗凝剂 (SHA) 的组合导致了最长的过器寿命.
- 同时使用肝素与过器凝血风险降低有关.
- 高水平的CRRT前血红蛋白和D-二元水平,以及过后的电离>0.4 mmol/L,与过器凝血风险的增加有关.
- 在接受联合RCA和SHA的组中,出血的发生率没有显著增加.
结论:
- 区域酸盐抗凝药与低剂量肝素结合是一种安全有效的策略,可以减少儿童CRRT患者的过器凝血,并延长过器寿命.
- 这种综合方法为这种高风险患者群体提供了改进的抗凝血方案.
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