CAJ | 학술논문

目的：探讨在连续性肾脏替代治疗(CRRT)联合血液灌流(HP)治疗且不能串联时，血滤机二种不同待机模式对滤器使用时间的影响。方法将50例妊娠合并高脂血症性胰腺炎的患者随机分为改良组和对照组，行 CRRT 6h 后改行 HP 一次，并以原血滤配套继续 CRRT 治疗，灌流期间血滤机回血后干预组进入暂停模式，对照组以肝素预冲液接于动脉端，静脉端接无菌引流袋，使血滤机低效运转。统计分析二组患者的凝血功能指标、滤器凝血指标和使用时间。结果二组 PT、APTT 差异无统计学意义。干预组跨膜压、滤器压力和使用时间均高于对照组，差异有统计学意义(P <0.05)。结论在必要性中断 CRRT治疗时，以模拟治疗方式使血滤机与常规的暂停模式比较能延长滤器使用时间，降低凝血风险和治疗费用，并且对患者凝血功能无影响。
목적：탐토재련속성신장체대치료(CRRT)연합혈액관류(HP)치료차불능천련시，혈려궤이충불동대궤모식대려기사용시간적영향。방법장50례임신합병고지혈증성이선염적환자수궤분위개량조화대조조，행 CRRT 6h 후개행 HP 일차，병이원혈려배투계속 CRRT 치료，관류기간혈려궤회혈후간예조진입잠정모식，대조조이간소예충액접우동맥단，정맥단접무균인류대，사혈려궤저효운전。통계분석이조환자적응혈공능지표、려기응혈지표화사용시간。결과이조 PT、APTT 차이무통계학의의。간예조과막압、려기압력화사용시간균고우대조조，차이유통계학의의(P <0.05)。결론재필요성중단 CRRT치료시，이모의치료방식사혈려궤여상규적잠정모식비교능연장려기사용시간，강저응혈풍험화치료비용，병차대환자응혈공능무영향。
Objective To compare the service time of hemofiltration system under two different standby modes when the renal replacement therapy(CRRT)was suspended during hemoperfusion (HP).Methods Totally 50 patients with acute pancreatitis in pregnancy caused by hyperlipidemia were randomly divided into improvement group and control groups.Both CRRT and HP were needed in these patients.HP was carried out after 6h CRRT and then CRRT was carried on using the original hemofiltration system.In the improvement group,hemofiltration system was running slowly in the simulated treatment mode by infusing heparin priming fluid through the arterial access and collecting it in a sterile drainage bag on the venous ac-cess.While in the control group,hemofiltration system was in the pause mode.The coagulation index of patients and filters,and the service time of hemofiltration system were compared between the two groups. Results There was no significant difference in prothrombin time (PT),activated partial thromboplastin time (APTT)between the two groups.In the improvement group,the transmembrane pressure,pressure in the filter were higher,and the service time was longer than the control group (P <0.05).Conclusions Compared with general pause mode,the simulated treatment mode can improve the service time of hemofil-tration system,decrease the coagulated risks of filters and the cost when CRRT has to be suspended,but also has no influence on the coagulation index of patients.