区域酸盐与肝素抗凝药在连续脏替代疗法中的有效性
Gaurav Bhandari1, Debarun Choudhury1, Anil Kumar Bhalla1
1Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India.
Indian journal of nephrology
|May 12, 2025
概括
区域性酸盐抗凝药可显著改善波器寿命和递送的RRT剂量,在接受连续脏替代疗法的急性损患者中,同时降低了与肝素相比的出血风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临界护理医学 临界护理医学
- 麻醉学 麻醉学
背景情况:
- 持续置换疗法 (CRRT) 对血液动力学不稳定的急性损伤 (AKI) 患者至关重要.
- 氨酸是CRRT中常见的抗凝剂,存在出血风险和氨酸诱导的血栓塞缩症.
- 区域酸盐抗凝剂 (RCA) 为CRRT提供了一个替代的抗凝剂策略.
研究的目的:
- 为了在AKI患者的CRRT中比较区域酸盐抗凝剂与肝素抗凝剂的疗效和安全性.
- 为了评估两个抗凝方法之间的过器寿命,输送的RRT剂量和出血发作之间的差异.
主要方法:
- 一个随机对照试验在1年内 (2020年10月 - 2021年9月) 在重症监护室进行.
- 52名需要CRRT的AKI患者被随机分为两个组:RCA (组1) 和肝素 (组2).
主要成果:
- 与肝素组 (26.11小时,P<0.001) 相比,RCA组的平均过器寿命显著更长 (45.11小时).
- 在RCA组 (26毫升/千克/小时) 和肝素组 (24.23毫升/千克/小时,P<0.001) 中观察到更高的有效输送的RRT剂量.
- 在RCA组中,出血发作明显较少 (11.5%),而不是在肝素组 (42.3%,P = 0.027).
结论:
- 区域酸盐抗凝剂在AKI患者的CRRT中优于肝素抗凝剂.
- 在延长过器寿命,改善RRT剂量递送和减少出血并发症方面,RCA提供了好处.
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