Ma Y J, Bai L, Tang H
Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu 610041, China.
Zhonghua Gan Zang Bing Za Zhi. 2020 Jun 20;28(6):532-535. doi: 10.3760/cma.j.cn501113-20200509-00238.
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.
肝衰竭是一种进展迅速、死亡率高的病症。人工肝治疗是肝衰竭最重要的治疗方法之一。为确保体外循环装置的顺利运行,临床实践中常使用肝素或低分子肝素等抗凝剂。然而,它会引发出血、血小板减少等不良反应,从而威胁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,也不影响血小板,因此体外循环抗凝已成为连续性肾脏替代治疗的首选抗凝治疗方法。结合国内外当前的研究状况,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,涵盖其原理内容、应用现状及应用前景。