国际移植与血液净化杂志
國際移植與血液淨化雜誌
국제이식여혈액정화잡지
INTERNATIONAL JOURNAL OF TRANSPLANTATION AND HEMOPURIFICATION
2015年
3期
15-18
,共4页
彭健韫%张小如%廖益飞%兰乐健
彭健韞%張小如%廖益飛%蘭樂健
팽건운%장소여%료익비%란악건
重症肾功能衰竭%间断性血液透析%持续缓慢低效血液透析
重癥腎功能衰竭%間斷性血液透析%持續緩慢低效血液透析
중증신공능쇠갈%간단성혈액투석%지속완만저효혈액투석
Severe renal failure%Intermittent hemodialysis%Sustained low efficiency hemodialysis
目的 观察持续缓慢低效血液透析(SLED)与常规间断性血液透析(IHD)对重症肾功能衰竭患者血液动力学的影响.方法 纳入重症肾功能衰竭患者20例,采用自身对照法分为两组,对照组(A组,n=20)行间断性血液透析4h,观察组(B组,n=20)行持续缓慢低效血液透析6h.治疗全程每小时记录平均动脉压(MAP)和心率(HR),记录一过性低血压发生情况.比较治疗前后两组患者中心静脉压(CVP)、尿素氮(BUN)、血肌酐(Scr)、血白蛋白(ALB)、血钾(K)、β2-微球蛋白(β2-MG)、心钠肽(BNP)水平.结果 持续低效缓慢血液透析与普通血液透析两种治疗低血压的发生率分别为20％和55％,差异有统计学意义(P＜0.05);两组治疗前MAP和HR无显著差别,治疗后30 min两组MAP均显著下降,HR增快,治疗后1和2h观察组MAP值上升,HR下降,与对照组比较差异有统计学意义(P＜0.05).两组治疗前后ALB差异无统计学意义,两种方法治疗后Scr、BUN、K、β2-MG、BNP、CVP下降(P＜0.01),SLED治疗后BUN、β2-MG、CVP、BNP下降,与IHD比较差异有统计学意义(P＜0.05).结论 在血液动力学方面,持续缓慢低效血液透析对重症肾功能衰竭患者的影响比间断性血液透析小,而且心功能改善更明显,毒素清除率更高,临床效果更好.
目的 觀察持續緩慢低效血液透析(SLED)與常規間斷性血液透析(IHD)對重癥腎功能衰竭患者血液動力學的影響.方法 納入重癥腎功能衰竭患者20例,採用自身對照法分為兩組,對照組(A組,n=20)行間斷性血液透析4h,觀察組(B組,n=20)行持續緩慢低效血液透析6h.治療全程每小時記錄平均動脈壓(MAP)和心率(HR),記錄一過性低血壓髮生情況.比較治療前後兩組患者中心靜脈壓(CVP)、尿素氮(BUN)、血肌酐(Scr)、血白蛋白(ALB)、血鉀(K)、β2-微毬蛋白(β2-MG)、心鈉肽(BNP)水平.結果 持續低效緩慢血液透析與普通血液透析兩種治療低血壓的髮生率分彆為20％和55％,差異有統計學意義(P＜0.05);兩組治療前MAP和HR無顯著差彆,治療後30 min兩組MAP均顯著下降,HR增快,治療後1和2h觀察組MAP值上升,HR下降,與對照組比較差異有統計學意義(P＜0.05).兩組治療前後ALB差異無統計學意義,兩種方法治療後Scr、BUN、K、β2-MG、BNP、CVP下降(P＜0.01),SLED治療後BUN、β2-MG、CVP、BNP下降,與IHD比較差異有統計學意義(P＜0.05).結論 在血液動力學方麵,持續緩慢低效血液透析對重癥腎功能衰竭患者的影響比間斷性血液透析小,而且心功能改善更明顯,毒素清除率更高,臨床效果更好.
목적 관찰지속완만저효혈액투석(SLED)여상규간단성혈액투석(IHD)대중증신공능쇠갈환자혈액동역학적영향.방법 납입중증신공능쇠갈환자20례,채용자신대조법분위량조,대조조(A조,n=20)행간단성혈액투석4h,관찰조(B조,n=20)행지속완만저효혈액투석6h.치료전정매소시기록평균동맥압(MAP)화심솔(HR),기록일과성저혈압발생정황.비교치료전후량조환자중심정맥압(CVP)、뇨소담(BUN)、혈기항(Scr)、혈백단백(ALB)、혈갑(K)、β2-미구단백(β2-MG)、심납태(BNP)수평.결과 지속저효완만혈액투석여보통혈액투석량충치료저혈압적발생솔분별위20％화55％,차이유통계학의의(P＜0.05);량조치료전MAP화HR무현저차별,치료후30 min량조MAP균현저하강,HR증쾌,치료후1화2h관찰조MAP치상승,HR하강,여대조조비교차이유통계학의의(P＜0.05).량조치료전후ALB차이무통계학의의,량충방법치료후Scr、BUN、K、β2-MG、BNP、CVP하강(P＜0.01),SLED치료후BUN、β2-MG、CVP、BNP하강,여IHD비교차이유통계학의의(P＜0.05).결론 재혈액동역학방면,지속완만저효혈액투석대중증신공능쇠갈환자적영향비간단성혈액투석소,이차심공능개선경명현,독소청제솔경고,림상효과경호.
Objective To observe the effects of sustained low efficiency hemodialysis and conventional intermittent hemodialysis on hemodynamics in patients with severe renal failure.Methods Twenty patients with severe renal failure were assigned to two groups:the control group (group A,n =20) obtained intermittent hemodialysis for 4 h,and the observation group (group B,n =20) were treated with sustained low efficiency hemodialysis for 6 h.Mean arterial pressure,heart rate and transient hypotension were observed.Before and after the treatment,central venous pressure,blood urea nitrogen,serum creatinine,serum albumin,serum potassium,beta 2-microglobulin and atrial natriuretic peptide were compared bewteen the two groups.Results The sustained low efficiency hemodialysis hypotension and slow hemodialysis treatment in two occurred in 20％ and 55％ respectively(P ＜ 0.05).MAP and HR showed no significant difference between the two groups before the treatment.After the treatment,two groups of 30 min and MAP decreased significantly,increased heart rate,observation group 1,2h map value increased,HR decreased significantly,and the control group (P ＜ 0.05) difference.ALB before and after treatment in two groups were not statistically significant difference statistically significant,SCR,urea nitrogen,potassium,beta 2-MG,BNP,CVP decreased after treatment with beta two methods (P ＜ 0.01),BUN after treatment,the sled,beta 2-MG,CVP,BNP decreased beta,the difference was statistically significant (ischemic heart disease,P ＜ 0.05).Conclusion Sustained low efficiency hemodialysis in patients with severe renal failure than the effect of intermittent hemodialysis is small,and the cardiac function was significantly improved,toxin removal rate is higher,better clinical effects.
