重症合并急性肾损伤患者血液透析早期滤器凝血相关因素的研究

doi:10.3969/j.issn.1002-1949.2016.05.0012

Chinese Journal of Critical Care Medicine

2016, Vol. 36

Issue (5): 434-438 DOI: 10.3969/j.issn.1002-1949.2016.05.0012

Study of patient factors associated with early clotting of dialysers during haemodiafiltration in critically ill patients with acute kidney injury

LI Ke-peng

Department of Critical Care Medicine，Wei?fang Peoples Hospital，Weifang 261041，China

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Abstract Objective To study patient factors associated with clotting of dialysers during haemo⁃diafiltration in critically ill patients with acute kidney injury. Methods Clinical data of 221 critically ill patients with acute kidney injury were collected. The patients were assigned to two groups according to clotting of dialysers in 24 hours and out 24 hours. Single factor and multiple factors logistic regression analysis were used to clarify factors associated with clotting of dialysers during haemodiafiltration in critically ill patients with acute kidney injury. Results Blood clotting platelet count，blood coagulation international standardization ratio（INR）and total bilirubin numerical comparison were significantly different（P＜0.05）between the two groups（189 patients with clotting of dialysers in 24 hours and 32 cases of out 24 hours）. In the process of single factor analysis，because of the small sample size of this study，a parsimony model was generated to increase the precision of the results by stepwise removal of factors that were associated with a P value＞0.20 in the full model. In this parsimony model，platelet count，total bilirubin，INR，low blood volume shock，hemorrhage，disturbance of consciousness condition were elected to the parsimony mode. Multiple factors analysis，the platelet count （odds ratio，OR＝1.074，95% CI 1.042~1.107; P＝0.000），the INR（odds ratio，OR＝7.425，95% CI 1.424~197.49; P＝0.002），bilirubin（odds ratio，OR＝1.074，95% CI 1.042~1.107; P＝0.000）are independent risk factors for the development of clotting of dialysers risky. Conclusion The high platelet count，low clotting international standard ratio and low total bilirubin are risk factors of early clotting of dialysers during haemodiafiltration in critically ill patients with acute kidney injury. Great attention should be paid during the clinical treatment.

Key words： Acute kidney injury丨Haemodiafiltration Clotting of dialysers丨Continuous veno venous hemodiafiltration（CVVHDF）

Received: 11 December 2015

About author:: LI Ke-peng，E-mail: likepengsuda@126.com

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Cite this article:

LI Ke-peng. Study of patient factors associated with early clotting of dialysers during haemodiafiltration in critically ill patients with acute kidney injury [J]. Chinese Journal of Critical Care Medicine, 2016, 36(5): 434-438.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2016.05.0012 OR http://www.cnemergency.org.cn/EN/Y2016/V36/I5/434

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