枸橼酸钠在crrt抗凝中补钙速率探讨-内科急危重症杂志.docVIP

枸橼酸钠在CRRT抗凝中补钙速率探讨 叶涛1 余追2 [摘要] 目的 探讨CRRT中用枸橼酸钠抗凝补钙的速率。方法 （1）45例CRRT治疗用枸橼酸钠抗凝的病人分成3组，三组患者给予相同置换液量（3000ml/h）,但补钙速率不同：1组 补钙速率为10%葡萄糖酸钙11ml/h（枸橼酸钙结合量）[1]相当于枸橼酸钠输注速率6.1%； 2组 补钙速率为10%葡萄糖酸钙22.5ml/h（相当于含钙配方置换液的钙含量）[2]； 3组 补钙速率为10%葡萄糖酸钙33.5ml/h（置换液钙含量+枸橼酸钙结合量） [3]。间隔2h测滤器前血清钙离子。（2）45例CRRT治疗用枸橼酸钠抗凝的病人分成3组，三组患者给予相同补钙速率10%葡萄糖酸钙22.5ml/h，但置换液量不同，置换量分别为2000ml，3000ml，4000ml，测滤器前血清离子钙。结果 （1）2h后，1组血液钙离子显著降低；3组血液钙离子高于正常值；2组2h后血钙正常，4h，8h保持稳定。（2）2h后，1组血液钙离子逐渐增大；3组血液钙离子逐渐减少；2组血液钙离子保持正常水平。结论 用枸橼酸抗凝，通过置换液量调整补钙速率是较为准确的方法，可作为调整补钙速率的重要参考依据。 [关键词] 局部枸橼酸抗凝； CRRT；钙 To investigate the infusion speed of calcium in regional citrate anticoagulation with CRRT YE Tao，Yu Zhuii,. ICU, Aikang hospital，Hubei Huangshi，435000，china 【Abstract】Objective To investigate the infusion speed of calcium in regional citrate anticoagulation RCA with continuous rental replacement therapy CRRT Methods 1 45 cases were selected randomly into 3 groups, were inputted the venous with the different infusion speed of calcium. Group 1：The infusion speed of calcium is 11ml/h equal to 6.1% velocity of citrate . Group 2：The infusion speed of calcium is 22.5ml/h equal to calcium content of substitute liquid .. Group 3：The infusion speed of calcium is 33.5ml/h equal to Group 1+Group 2 . 2 45 cases were selected randomly into 3 groups ,Monitoring the calcium content with substitute liquid capacity（2000ml,3000ml,4000ml）. Results : 1 After 2 hours, the calcium level of group 1 decrease；The calcium level of group 3 increase；The calcium level of group 2 is stable, After 4 hours and 6 hours, the calcium level of group 2 remain stable. 2 After 2 hours, the calcium ion concentration decrease with the increase of substitute liquid capacity. Conclusions The infusion speed of calcium is adjusted by substitute liquid capacity, which is important reference index. 【Key words】regional citrate anticoagulation ；continuous rental replacement therapy；calcium 局部枸橼酸盐抗凝可以满足体外血液净化抗凝的需求，对患者血液系统影响较小，在连续性肾脏替代治疗 CRRT 中得到广泛应用[1-2]。但是枸橼酸抗凝如何补钙，却有很多不同方