酸盐抗凝剂在治疗性血交换中的安全性和有效性:一项临床研究
Ciprian Gîndac1,2, Tamara Mirela Poroșnicu1,3, Nilima Rajpal Kundnani4,5
1Department of Anaesthesia and Intensive Care, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Clinics and practice
|October 28, 2025
概括
酸盐抗凝药是一种安全有效的治疗性血交换 (TPE) 替代品,特别是对于高凝性疾病患者. 这种方法有助于防止电路凝血,并在肝素无效或禁用时保存TPE套件.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 血液学 血液学 血液学
- 关键护理医学 关键护理医学
背景情况:
- 治疗性血交换 (TPE) 是一种至关重要的治疗方法,但在高凝血患者中,肝素抗凝药面临着挑战.
- 酸盐抗凝剂在其他体外疗法中使用,但在TPE中经常避免使用.
- 在TPE期间,电路凝血的风险增加,需要探索替代抗凝策略.
研究的目的:
- 在治疗性血交换期间评估酸盐抗凝剂的安全性和有效性.
- 评估酸盐在接受TPE的高凝血患者中预防电路凝血的效用.
- 为了确定酸盐是否可以在肝素禁用或失败时使用.
主要方法:
- 一项涉及26名患者和52次使用酸盐抗凝药的TPE疗程的研究.
- 在15名患者 (29次) 的治疗中,从一开始就开始使用酸盐,并且由于迫在眉的凝血风险,在11名患者 (23次) 的治疗中引入酸盐.
- 通过监测电路凝血和患者结果来评估有效性和安全性.
主要成果:
- 酸盐在23次肝素失败的治疗中21次成功阻止了电路凝血.
- 在29次用酸盐开始的TPE疗程中,有27次成功完成,即使在高凝血患者中也是如此.
- 在任何患者中都没有观察到酸盐毒性的情况.
结论:
- 酸盐抗凝剂是治疗性血交换的安全和可行的选择.
- 酸通过防止高凝血患者的凝血,有效地保护TPE套件.
- 酸盐提供了一个有价值的替代品,当肝素是禁忌或不够的TPE.
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