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连续性血液净化(CBP)作为重症监护室(ICU)中重要的器官支持手段,在肾脏及非肾脏领域应用广泛。CBP需建立长期体外循环,故保持管路通畅是顺利完成治疗的保障。肝素作为CBP中最常用的抗凝剂,其出血发生率高、易发生肝素诱导性血小板减少症(HIT)等不良反应,故在血液净化领域中的应用受限,尤其是具有出血倾向的患者。局部枸橼酸抗凝(RCA)作为新型的抗凝方式,其安全、有效,已逐渐被临床医师接受。近年来,RCA已成为临床研究的热点。
Continuous blood purification (CBP) is an important organ-supporting device in intensive care unit (ICU) and is widely used in the kidney and non-kidney areas. CBP need to establish long-term cardiopulmonary bypass, so to maintain the smooth patency is the guarantee of the successful completion of treatment. Heparin, the most commonly used anticoagulant in CBP, has a high rate of hemorrhage and is susceptible to adverse reactions such as heparin-induced thrombocytopenia (HIT) and is therefore limited in the field of blood purification, especially in patients with hemorrhagic tendency . As a new anticoagulation method, local citrate anticoagulation (RCA) is safe and effective and has gradually been accepted by clinicians. In recent years, RCA has become a hot spot in clinical research.