抗凝技术在危重症肾脏替代治疗应用的中国专家共识（2023年版）-1

中华肾脏病杂志2023年2月第39卷第2期Chin J Nephrol,February2023.Vdl.39,No.2·155··专家共识·抗凝技术在危重症肾脏替代治疗应用的中国专家共识(2023年版)共识专家组通信作者：梅长林，海军军医大学附属长征医院肾脏料，上海200003，Email:chlmei1954@126.com;丁峰，上海交通大学医学院附属第九人民医院肾脏科，上海200011,Email:dingfeng@sjtu.edu.cn【摘要】安全有效的抗凝是危重症患者肾脏替代治疗(renal replacement therapy,RRT)成功的关键，然而目前仍缺乏针对危重症患者RRT的抗凝指导和推荐。该共识由国内肾脏病、危重医学以及检验医学专家共同讨论制定，结合该领域的最新文献和国内外指南，介绍抗凝剂的作用机制和抗凝剂的选择，旨在指导和规范危重症患者RRT中的抗凝技术应用。【关键词】血液凝固；抗凝血药；危重病；肾替代疗法；专家共识Chinese expert consensus on the application ofanticoagulant technology in renal replacementtherapy for critical patients(2023)Expert Consensus Working GroupCorresponding author:Mei Changlin,Department of Nephrology,Changzheng Hospital Affiliated toNaval Medical University,Shanghai 200003,China,Email:chlmei1954@126.com;Ding Feng,Departmentof Nephrology,the Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School ofMedicine,Shanghai 200011,China,Email:dingfeng@sjtu.edu.cnAbstract)Safe and effective anticoagulation is the key for successful renal replacementtherapy(RRT)in critical patients.However,there is still a lack of guidance and recommendation onanticoagulation for RRT in critical patients.Combined with the latest literature and guidelines in thisfield,this consensus was jointly formulated by nephrologists,intensive care and clinical laboratoryspecialists in China.It introduces the mechanisms of anticoagulants and the selection ofanticoagulants,and aims to guide and standardize the application of anticoagulation technology inRRT for critical patients.【Key words】Blood coagulation;Anticoagulants;Critical illness;Renal replacementtherapy;Expert consensus危重症患者病情严重、危急、多变，常合并多器官功能和规范危重症患者RRT中的抗凝技术应用。衰竭，急性肾损伤(acute kidney injury,AKI)的发生率可高达50%。全身炎性反应综合征、多脏器功能障碍综合征合一、共识形成方法并的重症AKI常需要体外多器官功能支持治疗。肾脏替代本共识专家组由全国具有丰富临床经验的肾脏病、危治疗(renal replacement therapy,RRT)是器官支持治疗中的重医学以及检验医学专家组成，通过检索Pubmed数据库、重要组成部分，安全有效的抗凝是RRT顺利实施的关键，然万方数据库、中国知网搜索国内外文献，主要检索词为血液而抗凝剂种类繁多，危重症患者抗凝需求不一，迄今仍缺乏透析、肾脏替代治疗、抗凝、hemodialysis、kidney/renal针对危重症患者RRT的抗凝指导和推荐。本共识由国内肾replacement therapy、anticoagulation,形成共识文献库。专家脏病、危重医学以及检验医学专家共同讨论制定，旨在指导组成员根据国内外最新指南、文献及临床经验，经过数次线D0L:10.3760/cmaj.cm441217-20220809-00815收稿日期2022-08-09本文编辑杨克魁引用本文：共识专家组.抗凝技术在危重症肾脏替代治疗应用的中国专家共识(2023年版)中华肾脏病杂志，2023.392上155-164.D0L:10.3760/cma.j.cm441217-20220809-00815