SLED与CVVH血液动力学比较  

A hemodynamic comparison of results of continuous slow low-efficiency hemodialysis and continuous veno-venous hemofiltration therapy

作　　者：李洪[1] 曾丽花[1] 卢飞杏[1] 吴红兰[1] 苏庆玲[1] 陈业珍[1] 欧阳陪花[1] 林芳[1] 曾欣[1] 

机构地区：[1]海南省人民医院血液净化中心,海南海口570311

出　　处：《中国热带医学》2007年第7期1095-1097,共3页China Tropical Medicine

基　　金：海南省自然科学基金(80456)

摘　　要：目的比较持续缓慢低效血液透析(SLED)与持续静脉静脉血液滤过(CVVH)在重症肾衰竭患者治疗中的血液动力学变化。方法采用前瞻开放设计,交叉对照方法,以清洗期12～24h,20例重症肾衰竭患者分别被随机施以SLED和CVVH治疗10h,治疗全程每小时记录平均动脉压、心率、超滤率,记录一过性低血压的发生情况、血管活性药和胶体的使用情况。结果CVVH组平均超滤率(0.262±0.296)L/h,总超滤平均每例(3.296±1.953)L,平均动脉压(102.760±19.494)mmHg,平均心率(89.550±21.203)次/min,一过性低血压发生率16/20;SLED组平均超滤率(0.420±0.333)h,总超滤平均每例(5.403±2.956)L,平均动脉压101.438±19.331,平均心率97.705±21.799,一过性低血压发生率15/20;SNK方差分析显示SLED组每小时超滤率、总超滤率、心率比CVVH组显著增高(P<0.01);但两组治疗之间MAP无差异(P>0.01)。结论SLED在重症肾衰竭患者治疗中血液动力学像CVVH一样稳定,甚至在总超滤量明显大于CVVH时也未明显增多低血压的发生。Objective To compare the hemodynamic change of continuous slow low - efficiency hemodialysis （SLED） and continuous veno - venous hemofiltration （CVVH） therapy on severe renal failure patients. Methods The observation was prospectively open designed and cross over controlled, 20 severe renal failure patients were treated with SLED and CVVH for a duration of 10 hours respectively. The value of MAP, the rate of UF, the levels of total UF, BP, HR, transient hypotension, blood vessel inotropic support and colloid applied were recorded. SNK - students analysis was used for analysis of the hemodynamic effect of the above two therapies. Results The average rate of UF in CVVH group was 0.262± 0.296L/h; average level of total UF was 3.296 ± 1. 953L/case; Average value of MAP was 102. 760 ± 19. 494mmHg; average HR was 89. 550 ± 21. 203/min; transient hypotensionrate was 45%. With regard to the SLED group the rate of UF; the levels of total UF, MAP, HR and transient hypotension were 0.420±0.3331/h, 5.403 ± 2.956L, 101.438 ± 19.331mmHg, 97.705 ± 21.799/min and 75%, respectively. The rate pf UF per hour, total UF, HR were higher in SLED group as comared with that of CVVH group （ P 〈 0.01 ）. But no significant differences were observed in the values of MAP in the two groups （ P 〉 0.05）. Conclusion The effect of SLED is as stable as that of CVVH in treatment of severe renal failure patients.

关 键 词：肾衰竭 血液净化 持续缓慢低效血液透析 持续静脉静脉血液滤过 

分 类 号：R495.5[医药卫生—康复医学]