摘要目的 研究2.5%枸橼酸钠在带cuff中心静脉导管封管时的有效性、安全性及经济性。方法 选择以带cuff中心静脉导管作为血管通路进行透析患者26例。按入院顺序单双号分为枸橼酸组与肝素组。枸橼酸组在透析结束时使用2.5%枸橼钠注入导管进行封管,肝素组使用5%肝素钠。观察封管后不良反应;比较封管前后活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、血钙水平变化;统计导管功能不良的发生率,比较两种方法封管治疗费用等。结果 枸橼酸组封管前后PT[(11.55±1.11)s vs (12.75±3.68)s]、APTT[(28.91±4.35)s vs (28.02±3.88)s]、血钙[ (1.25±0.08)mmol/L vs (1.22±0.07) mmol/L ]无明显变化;而肝素组PT[ (11.30±1.85 )s vs (12.75±1.32)s]、APTT[(28.31±3.45)s vs (33.44±3.21)s]在封管后都延长,差异有统计学意义(P<0.01);两组导管功能不良发生率、导管感染发生率均没有统计学差异;枸橼酸组平均治疗费用较肝素组低[0.55元/次 vs 22元/次]。结论 2.5%枸橼酸钠用于带cuff中心静脉导管封管安全、有效、经济,可以常规代替肝素钠。
Abstract：Objective To evaluate the effectiveness, safety and economy of sodium citrate 2.5% as lock solution for tunneled cuffed dialysis catheter. Methods Sodium citrate 2.5% versus 5% heparin were used as lock solution in the study group and control group. Adverse effect, including bleeding, hypocalcaemia seizures, and lip numbness were observed; the APTT, PT and serum calcium before and after catheter locked, catheter malfunction incidence, the use of thrombolytics and average cost were compared. Results Sodium citrate 2.5% did not affect the APTT[(28.91?4.35 )s vs (28.02?3.88)s], PT[(11.55?1.11) s vs (12.750?3.68) s], serum calcium [(1.25?0.08) mmol/L vs (1.22?0.07) mmol/L], while heparin prolonged PT[(11.30?1.85)s vs (12.75?1.32)s], APTT[(28.31?3.45)s vs (33.44?3.21)s], no difference was observed in incidence of catheter malfunction and infection, the average cost in citrate group was much cheaper than that of heparin group[0.55 yuan/one time vs 22 yuan/one time]. Conclusions Sodium citrate 2.5% is a safe and effective agent for tunneled cuffed dialysis catheter lock. It can be used alternatively as catheter lock solution besides heparin.
曹正江,李梨. 带cuff中心静脉导管两种封管剂效果比较[J]. , 2014, 25(6): 547-549.
CAO Zhengjiang and LI Li. Comparison of two kinds of solutions for tunneled cuffed dialysis catheter. , 2014, 25(6): 547-549.
2014, Vol. 25 
