使用含替代溶液的区域酸盐抗凝药在连续替代疗法的不同方式中的有效性和安全性:一项随机对照试验
Peiyun Li1, Mingpeng Li1,2, Wanhong Yin3
1Department of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, Chengdu, 610041, China.
BMC nephrology
|November 6, 2025
概括
使用含液的区域酸盐抗凝剂 (RCA) 在连续置换疗法 (CRRT) 中是安全的. 与其他CRRT方式相比,连续静脉静脉血过 (CVVHDF) 显示出更高的电路存活率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 关键护理医学 关键护理医学
背景情况:
- 区域酸盐抗凝剂 (RCA) 是持续置换疗法 (CRRT) 的首选抗凝剂方法.
- 在不同CRRT方式中,RCA与含替代液的疗效需要进一步研究.
研究的目的:
- 通过使用含的替代液体,在三个模式中比较RCA-CRRT的有效性和安全性:连续静脉静脉血过 (CVVH),连续静脉静脉透析 (CVVHD) 和连续静脉静脉血过 (CVVHDF).
主要方法:
- 一个开放的,三臂的随机试验,涉及121名AKI患者接受RCA-CRRT与含的替代液体.
- 患者被分配到CVVH,CVVHD或CVVHDF组.
- 主要结局包括电路寿命和早期电路故障;次要结局是安全性和30天死亡率.
主要成果:
- 与CVVHD (47小时) 和CVVH (64小时) 相比,CVVHDF的电路寿命显著更长 (70小时) (P < 0.001).
- 早期电路故障 (<48小时) 的发生率在CVVHDF (12.2%) 与CVVHD (52.5%) 和CVVH (22.5%) (P = 0.004) 相比显著较低.
- 与CVVHD (50%) 和CVVH (5%) 相比,CVVHDF还显示严重静脉腔血栓的发生率显著降低 (2.4%),P<0.001).
结论:
- 使用含替代溶液的区域酸盐抗凝剂 (RCA) 在CRRT中安全有效.
- 持续静脉血液过 (CVVHDF) 可以延长过器的存活时间,这表明它在临床实践中是一个可行的选择.
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