两种不同抗凝方法在危重症患者连续性肾脏替代治疗中的比较研究

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1、授予单位代码10089学号或申请号13451对妗(E科大迳HebeiMedicalUniversity在职科学学位两种不同抗凝方法在危重症患者连续性肾脏替代治疗中的比较研究学位申请人：魏晓华导师：胡振杰教授刘丽霞教授专业：急诊医学2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组)的指导下，由本人独立完成。本学位论文研究所获得的研究成果,其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文,第一署名为单位河

2、北医科大学，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则,承担相应法律责任。研究生签名导师签章级学院领导盖章：^ois年夕月河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果,除了文中特别加以标注和致谢等内容外,文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写,文责自负。目录中文摘要·································································

3、············1英文摘要·············································································3英文缩写·············································································6研究论文两种不同抗凝方法在危重症患者连续性肾脏替代治疗中的比较研究前言···········································

4、··································7材料与方法····································································8结果·············································································10附图·······························································

5、··············12附表·············································································13讨论·············································································20结论···········································································

6、··23参考文献·······································································23综述连续性肾脏替代治疗抗凝方式的研究现状··························25致谢···················································································33个人简历···································

7、··········································34中文摘要两种不同抗凝方法在危重症患者连续性肾脏替代治疗中的比较研究摘要目的：连续性肾脏替代治疗（continuousrenalreplacementtherapyCRRT）是危重症患者治疗领域的重大进步，它能够清除炎症介质、维持内环境稳定、替代肾脏功能。但安全有效的抗凝是CRRT顺利进行的重要保证，本研究旨在对低分子肝素和局部枸橼酸两种抗凝方法进行比较研究，以期为CRRT的抗凝治疗提供更好的依据和方案。方法：将行CRR

8、T治疗的危重症患者随机分组为低分子肝素组（A组）和局部枸橼酸组（B组），均选择连续性静脉-静脉血液滤过（CVVH）模式，血管通路采用经股静脉置入12F16cm双腔中心静脉导管。CRRT应用PRISMAFLEX血滤机（GAMBRO）和AN69滤器（M100膜面积20.9m），置换液3000ml/h，前置换75%，后置换25%，血流速度100-150ml/min。血液滤过开始前用含肝素钠1.25万单位的生理盐水2L预冲滤器及管路，