Abstract: Objective： To evaluate the anticoagulant efficacy and safety of nafamostat mesylate (NM) in patients undergoing hemodialysis. Methods： A total of 100 patients undergoing hemodialysis in our hospital between January 2023 and August 2024 were randomly assigned to either the observation group (NM) or the control group (standard anticoagulant heparin)， with 50 patients in each group. The anticoagulant efficacy， coagulation function， acid-base balance， and plasma electrolyte levels were compared between the two groups. Results： The total effective rate of anticoagulation in the observation group was 90.0%， higher than that of the control group（60.0%） (P<0.001). The observation group showed less fibrin deposition in the dialyzer and tubing， and more stable coagulation function (P>0.05). The APTT in vivo of the observation group was significantly prolonged at 2， 4 h after dialysis (P<0.05). The coagulation function of the observation group was better than that of the control group 4 h after dialysis (P<0.05). There was no statstic difference in pH， Na+， K+and other acid-base balance， electrolyte levels， and bleeding complications between the two groups before and after dialysis (P>0.05). Conclusion： Nafamostat mesylate demonstrates superior anticoagulant efficacy compared to traditional anticoagulants in hemodialysis， with a higher safety profile. NM effectively prevents fibrin deposition during dialysis， maintains the patency of the dialyzer， and reduces bleeding risks.

Key words: font-size:medium, ">Hemodialysis； Nafamostat mesylate； Anticoagulant efficacy； Safety； Coagulation function