Effect of local citric acid anticoagulation on dialysis adequacy and coagulation function in main-tenance hemodialysis patients with gastrointestinal bleeding
Objective To study the effect of local citric acid anticoagulation on dialysis ade-quacy and coagulation function in maintenance hemodialysis patients with gastrointestinal bleeding.Methods The clinical data of 69 patients with maintenance hemodialysis with gastrointestinal bleeding admitted to our hospital from June 2020 to December 2022 were retrospectively analyzed and divided into groups A,B and C,23 cases in each group.Group A and B used 4％sodium citrate simplified anticoagulant method.The dialysis time was 4 h,200 mL/h in group A and group B in 300 mL/h.Group C used conventional heparin free saline irrigation method.Renal function,coagulation function,anticoagulation effect,dialysis time,completion rate,and dialysis adequacy were compared in the three groups.Results After treatment,the differences in serum creatinine(Scr)and urea nitrogen(BUN)were lower than those before treatment(all P＜0.01).The serum Scr and BUN levels in group B were lower than those in group A and C,respectively(all P＜0.001).The filters in group B were higher than in A and C(95.65％vs.82.61％vs.60.87％,P＜0.001)and higher in group B than in A and C(82.61％vs.69.57％vs.47.83％,P＜0.05).Compared with group A and group C,the optimal dialysis completion rate and dialysis time in group B were statistically significant(all P＜0.05).The solute clearance index(Kt/V)and urea clearance(URR)in group B were higher than that of group A and C,respectively(all P＜0.05).Conclusions The application value of local citric acid anticoagulation in the treatment of digestive tract bleeding accompanied by maintenance he-modialysis is higher than that of conventional normal saline irrigation without heparin,and the effect of high-dose sodium citrate is better than that of low-dose sodium citrate,which can improve renal func-tion,improve clinical anticoagulation effect,dialysis adequacy and completion rate,and the coagula-tion function of patients has no influence.
Hemorrhage of Digestive TractMaintenance HemodialysisSodium CitrateBlood CoagulationAdequacy of Dialysis
万方数据
维普
