上海交通大学学报（医学版）
上海交通大學學報（醫學版）
상해교통대학학보（의학판）
JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY(MEDICAL SCIENCE)
2009年
7期
858-861
,共4页
王咏梅%张伟明%王炳顺%陆任华%方燕%戴慧莉%蒋蓉%余文英%严玉澄%钱家麒
王詠梅%張偉明%王炳順%陸任華%方燕%戴慧莉%蔣蓉%餘文英%嚴玉澄%錢傢麒
왕영매%장위명%왕병순%륙임화%방연%대혜리%장용%여문영%엄옥징%전가기
高通量透析%透析器%清除率%护理
高通量透析%透析器%清除率%護理
고통량투석%투석기%청제솔%호리
high-flux hemodialysis%dialyzer%clearance%care
目的 研究REXEEDTM系列透析器的溶质清除特性,讨论护理特点.方法 规律性血液透析患者18例,采用随机化交叉和3×3拉丁方实验设计,每例患者分别运用REXEEDTM-15AC、15UC和对照透析器APS-15U进行血液透析治疗.于透析器血液入、出口处采血测定尿素氮、肌酐、磷、β2-微球蛋白,计算溶质清除率;在每使用一种透析器的第3次透析前后,采血测定息者血尿素氮和肌酐水平,计算下降比率.严密观察患者生命体征,监测透析机的静脉压和跨膜压数值.结果 REXEEDTM-15AC和REXEEDTM-15UC透析器的尿素氮清除率显著大于APS-15U透析器(P<0.05);REXEEDTM-15AC透析器肌酐清除率显著大于APS-15U透析器(P<0.05).同一患者使用不同透析器的血尿素氮下降比率比较差异无统计学意义(均>65%).血液透析过程中,患者生命体征稳定,无不良反应发生;实验室安全性指标监测未见异常.结论 REXEEDTM系列透析器临床使用安全、有效.透析护理过程中,必须加强观察并重视患者的不适主诉;对于超滤量少的患者,可在适当补充液体的同时增加超滤量,以提高跨膜压,防止反超.
目的 研究REXEEDTM繫列透析器的溶質清除特性,討論護理特點.方法 規律性血液透析患者18例,採用隨機化交扠和3×3拉丁方實驗設計,每例患者分彆運用REXEEDTM-15AC、15UC和對照透析器APS-15U進行血液透析治療.于透析器血液入、齣口處採血測定尿素氮、肌酐、燐、β2-微毬蛋白,計算溶質清除率;在每使用一種透析器的第3次透析前後,採血測定息者血尿素氮和肌酐水平,計算下降比率.嚴密觀察患者生命體徵,鑑測透析機的靜脈壓和跨膜壓數值.結果 REXEEDTM-15AC和REXEEDTM-15UC透析器的尿素氮清除率顯著大于APS-15U透析器(P<0.05);REXEEDTM-15AC透析器肌酐清除率顯著大于APS-15U透析器(P<0.05).同一患者使用不同透析器的血尿素氮下降比率比較差異無統計學意義(均>65%).血液透析過程中,患者生命體徵穩定,無不良反應髮生;實驗室安全性指標鑑測未見異常.結論 REXEEDTM繫列透析器臨床使用安全、有效.透析護理過程中,必鬚加彊觀察併重視患者的不適主訴;對于超濾量少的患者,可在適噹補充液體的同時增加超濾量,以提高跨膜壓,防止反超.
목적 연구REXEEDTM계렬투석기적용질청제특성,토론호리특점.방법 규률성혈액투석환자18례,채용수궤화교차화3×3랍정방실험설계,매례환자분별운용REXEEDTM-15AC、15UC화대조투석기APS-15U진행혈액투석치료.우투석기혈액입、출구처채혈측정뇨소담、기항、린、β2-미구단백,계산용질청제솔;재매사용일충투석기적제3차투석전후,채혈측정식자혈뇨소담화기항수평,계산하강비솔.엄밀관찰환자생명체정,감측투석궤적정맥압화과막압수치.결과 REXEEDTM-15AC화REXEEDTM-15UC투석기적뇨소담청제솔현저대우APS-15U투석기(P<0.05);REXEEDTM-15AC투석기기항청제솔현저대우APS-15U투석기(P<0.05).동일환자사용불동투석기적혈뇨소담하강비솔비교차이무통계학의의(균>65%).혈액투석과정중,환자생명체정은정,무불량반응발생;실험실안전성지표감측미견이상.결론 REXEEDTM계렬투석기림상사용안전、유효.투석호리과정중,필수가강관찰병중시환자적불괄주소;대우초려량소적환자,가재괄당보충액체적동시증가초려량,이제고과막압,방지반초.
Objective To evaluate the solute clearance characteristics of REXEEDTM series dialyzers during high-flux dialysis, and explore the care characteristics. Methods A randomized crossover study of 3×3 Latin square was designed based on different dialyzers. Eighteen patients with regular hemodialysis underwent dialysis with REXEEDTM-15AC dialyzer, REXEEDTM-15UC dialyzer and controlled APS-15U dialyzer, respectively. Blood samples were obtained from the blood flow entrance and exit of dialyzers, levels of urea nitrogen, creatinine, phosphate and β2-microglobulin were detected, and solute clearance rates were calculated. Before and after the third dialysis with each dialyzer, blood samples were obtained to measure the levels of urea nitrogen and creatinine, and the rates of decrease were calculated. The vital signs of each patient were intensively observed, and the venous pressure and transmembrane pressure were monitored from the dialyzers. Results The urea nitrogen clearance rates of REXEEDTM-15AC dialyzer and REXEEDTM-15UC dialyzer were significantly higher than that of APS-15U dialyzer (P<0.05). The creatinine clearance rate of REXEEDTM-15AC dialyzer was significantly higher than that of APS-15U dialyzer(P<0.05). There was no significant difference in the rate of decrease in blood urea nitrogen among different dialyzers of the same patient(>65 % for all patients). The vital signs were stable with no adverse events during dialysis, and there was no abnormal findings in laboratory security parameters. Conclusion REXEEDTM series dialyzers are effective and safe for clinical application. Great importance should be attached to the complaints from patients during dialysis. For those with less ultrafiltration, fluid as well as uhrafiltration should be supplemented to increase the transmembrane pressure.
