肝衰竭病情进展快，病死率高。人工肝治疗是肝衰竭的重要治疗手段之一。为保障体外循环装置的顺利运行，临床实践中常采用肝素或低分子肝素抗凝，但其诱发出血及血小板减少等不良反应威胁了肝衰竭患者的生命安全。局部枸橼酸抗凝不影响体内凝血机制，对血小板也无影响，仅在体外循环抗凝，已成为连续性肾脏替代治疗的首选抗凝方式。现结合国内外的研究现状，探讨局部枸橼酸抗凝在人工肝治疗肝衰竭中的应用研究进展，内容涵盖抗凝原理、应用现状及应用前景。“,”Liver failure is a rapidly progressive condition with a high mortality rate. Artificial liver treatment is one of the most important treatments for liver failure. In order to ensure the smooth functioning of in vitro circulation device, anticoagulants such as heparin or low-molecular-weight heparin are often used in clinical practice. However, it induces hemorrhage, thrombocytopenia and other adverse reactions, thereby threatening the life safety of liver failure patients. Regional citrate anticoagulation does not affect the coagulation mechanism in vivo, nor does it effects platelets, so in vitro circulating anticoagulants has become the first choice anticoagulant treatment method for continuous renal replacement therapy. Combined with the current research condition at home and abroad, the research progress of the application of regional citrate anticoagulation in artificial liver to treat liver failure is discussed, covering its principle content, application status and application prospect.