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The Application of Regional Citrate Anticoagulation in Continuous Blood Purification in Patients with MODS

Author: BaiHeTiNiSha·TuErDi
Tutor: WangZaiYi
School: Xinjiang Medical University
Course: Surgery
Keywords: MODS Continuous blood purification Coagulation Sodium citrate
CLC: R459.7
Type: Master's thesis
Year: 2010
Downloads: 24
Quote: 0
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Abstract


Objective: To investigate patients with MODS regional citrate anticoagulation in continuous blood purification ( CBP ) on blood coagulation and therapeutic effect . Methods: in our hospital from June 2009 to October 2010 implementation of continuous blood purification ( CBP ) of 35 patients with MODS were randomly divided into 2 groups, regional citrate anticoagulation group (A ) and heparin group (B ) . Monitoring MODS score coagulation correlation between the CBP the two groups before treatment , MODS score of 24 hours after treatment , coagulation , blood gas and biochemical indicators of change ; the observed cardiopulmonary bypass coagulation , filter life and clinical bleeding events . Results: 1 ) the coagulation of the two groups of the CBP treatment modalities for patients had no significant effect ( P GT ; 0.05 ) ; 2 ) in the two groups of patients in the process of the CBP , 0,2,4,6,8,10,12 PBE hours each time point , PV , TMP have group differences ( P lt ; 0.05 ) , the average life of the filter was 29.84 ± 21.34 hours average life of the filter of the B group was 12.46 ± 17.13 hours , group A filter than B leader the difference was statistically significant ( P lt ; 0.05 ) ; 3 ) A group within 24 hours to replace the filter frequency and accounting for the 5.9 % of the number of group A , group B within 24 hours, the number of replacement accounted for 88.9% of group B , the two groups The difference was statistically significant ( P lt ; 0.05 ) ; 4 ) A , B two groups after CBP , creatinine, urea , MODS score than before treatment were significantly reduced , and the difference was statistically significant ( P lt ; 0.05 ) , A group of creatinine reduced after treatment more significant than the difference was statistically significant ( P lt ; 0.05 ) in group B ; 5 ) A group of CBP treatment , ICA , sodium , HCO3 level compared with pre - treatment difference was not statistically significant ( P GT ; 0.05 ) pH in group A after treatment than before treatment increased , the difference was statistically significant ( P lt ; 0.05 ) ; 6 ) two groups of patients were not bleeding complications after dialysis . 7 ) MODS score and critically ill patients coagulation correlation ( P lt ; 0.05 ) . CONCLUSION : MODS underwent continuous blood purification ( CBP ) in the treatment of regional citrate anticoagulation ( RCA ) method is safe and effective , had no effect on the patient's coagulation , could significantly prolong the service life of the filter , no bleeding complications .

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CLC: > Medicine, health > Clinical > Therapy > Emergency, first aid
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