Abstract：Objective: To observe the curative effect of heparin-free hemodiafiltration on uremia with upper gastrointestinal bleeding. Methods: 120 patients with uremia complicated with upper gastrointestinal bleeding in our hospital from January 2013 to January 2017 were randomly divided into two groups, 60 cases in each group. Group A was treated with local citrate anticoagulant hemodialysis, and group B was treated with heparin-free hemodiafiltration. The activated partial thromboplastin time (APTT), activated clotting time (ACT), pH of gastric juice, blood biochemical indicators and blood gas analysis before and after dialysis were compared between the two groups. The occurrence of dialyzer and tube coagulation in both groups was observed. Results: After dialysis, the APTT and ACT in group B were significantly shorter than those in group A (P<0.05), and the pH of gastric juice was significantly higher than that in group A (P<0.05). The levels of BUN and SCr in group B were significantly lower than those in group A (P<0.05). There were no significant differences in the level of Ca2+ or K+ or blood pH between the two groups (P>0.05). The HCO3- levels in group B were significantly lower than those in group A (P<0.05). There was no significant difference in the incidence of coagulation between group A and group B (10.00% vs 13.33%) (P>0.05). Conclusion: Heparin-free hemodiafiltration for uremia with upper gastrointestinal bleeding can effectively improve the renal function and pH of gastric juice, and correct potassium abnormalities. Local citrate anticoagulant hemodialysis is superior to heparin-free dialysis in terms of extracorporeal circulation.
邓成爱, 卢丽华, 吴琦. 无肝素透析滤过治疗尿毒症并上消化道出血60例[J]. 河北医学, 2019, 25(2): 272-275.
DENG Cheng'ai, LU Lihua, WU Qi. Heparin-free Dialysis and Filtration in the treatment of 60 cases of Uremia Complicated with Upper Gastrointestinal Bleeding. HeBei Med, 2019, 25(2): 272-275.
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2019, Vol. 25 
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