目的：研究枸橼酸钠局部抗凝在急性中毒患者血液灌流中的应用价值。方法将本院2011年7月~2014年8月80例急性中毒行血液灌流治疗患者抽签随机分为观察组与对照组，各40例，观察组给予枸橼酸钠治疗，对照组给予低分子肝素钙治疗，比较两组各时段跨膜压及血小板、HCO3-、Na+、iCa2+、APTT改变。结果观察组治疗后2、4 h跨膜压分别为（98.02±3.21）、（99.10±6.42）mm Hg，低于对照组的（125.34±2.16）、（189.30±7.15）mm Hg，差异有统计学意义（P<0.05）；观察组治疗后APTT为（7.21±5.10） s，短于对照组的（24.30±4.13） s，差异有统计学意义（P<0.05）；两组治疗后的血小板计数、HCO3-、iCa2+、Na+比较差异无统计学意义（P>0.05）。结论枸橼酸钠局部抗凝应用于中毒患者血液灌流安全可靠，具有较高的临床应用价值。%Objective To study the application value of sodium citrate anticoagulant in the treatment of patients with a-cute poisoning in hemoperfusion. Methods 80 patients with acute poisoning treated with hemoperfusion in our hospital from July 2011 to August 2014 were selected and randomly divided into observation group and control group,40 cases in each group.Citrate was taken to control group,low molecular weight heparin calcium was taken to observation group. The change of trans-membrane pressure,platelet,HCO3-,Na+,iCa2+ and APTT in each period between two groups were compared. Results After treatment of 2,4 hours,trans-membrane pressure of observation group was(98.02+3.21),(99.10+6.42) mm Hg respectively,significantly lower than that of control group respectively[(125.34+2.16),(189.30+7.15) mm Hg], with statistical difference(P<0.05).After treatment,APTT of observation group was (7.21+5.10) s,shorter than that of con-trol group[(24.30+4.13) s],with statistical difference (P<0.05).The platelet count,HCO3-,iCa2+and Na+between two groups was compared respectively,with no statistical difference (P>0.05). Conclusion The application of regional citrate antico-agulation in rescuing the acute poisoning patients treated with hemoperfusion is safe and reliable,which has a high val-ue in clinical application.
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