血液透析中抗凝剂的临床应用.ppt

血液透析中抗凝剂的临床应用湛江中心人民医院肾内科曾蕾凝血瀑布VII因子激活X因子激活凝血酶原转化为凝血酶纤维蛋白原的转化血液净化抗凝的目标理想抗凝剂血液净化治疗的抗凝技术肝素抗凝技术抗凝血酶抗凝血酶肝素抗凝技术肝素抗凝技术肝素抗凝技术的监测肝素抗凝技术肝素抗凝技术肝素相关性血小板减少肝素相关性血小板减少肝素相关性血小板减少抗凝剂对维持性血液透析病人脂质代谢的影响低分子量肝素抗凝低分子肝素低分子量肝素抗凝低分子量肝素抗凝27分子量与抗凝活性ATIII30LinhardtRJ,GunayNS.SeminThrombHemost1999;25(suppl3):5-16J.Fareed,J.M.Walenga,D.Hoppensteadtetal.
BiochemicalandPharmacologicInequivalenceofLowMolecularWeightHeparins.
AnnN.Y.Acad.Sci.1989;556:333-353欧洲药典显示低分子肝素依诺肝素的抗Xa/IIa比值最高：4.1CollignonetalThrombHaemost1995;73(4):630-40
ErikssonetalThrombHaemost1995;73(3):398-401无抗凝剂血液净化治疗枸橼酸抗凝原理枸橼酸抗凝枸橼酸抗凝Scanningelectronmicrographsoftheinnersurfaceofapolysulfonehollowfiberdialyzermembraneusingsodiumcitrateasanticoagulantduringhemodialysistherapy.Onlyafewsinglecellsadheringtotheinnersurfacewereobserved.Nothrombusformationwasseen.Similarobservationsweremadeinthedialyzersobtainedfromtheotherfourpatients.

Scanningelectronmicrographsoftheinnersurfaceofapolysulfonehollowfiberdialyzermembraneusingheparinasanticoagulantduringhemodialysistherapy.(A)Overviewshowingadensefibrinnetworkwithlargeamountsofaggregatederythrocytes.(B)Pseudomembraneousformation(magnificationoflowerframeinpanelA)ofaggregatederythrocytes.(C)Magnificationofaggregatederythrocytes(magnificationofupperframeinpanelA).Similarobservationsweremadeinthedialyzersobtainedfromtheotherpatients.

Scanningelectronmicrographsoftheinnersurfaceofapolysulfonehollowfiberdialyzermembraneusinglowmolecularweightheparinasanticoagulantduringhemodialysistherapy.(A–C)Astrongerfibrinnetworkisshown,butmuchlesserythrocytes.(D)Aplateletinafibrinnetworkusingahighmagnification.枸橼酸配方枸橼酸抗凝的操作枸橼酸抗凝的操作枸橼酸抗凝的操作枸橼酸抗凝的操作47枸橼酸抗凝的监测枸橼酸抗凝的副作用枸橼酸抗凝的临床应用CVVHF中滤器失功原因分析枸橼酸抗凝的肝衰竭患者中的应用枸橼酸抗凝的临床应用枸橼酸抗凝的临床应用枸橼酸抗凝中全血ACT的变化枸橼酸抗凝在普通血液滤过中的应用置换液剂量对枸橼酸蓄积的影响CRRT中低钙血症发生率抗凝剂的选择使用抗凝剂的注意事项