在线尿素清除率测量有效性及安全性评价  

The clinical efficiency and safety of online clearance measurement

作　　者：刘皤娜[1,2] 尹良红[2] 张子勇[1] 

机构地区：[1]暨南大学理工学院生物材料科学与工程系,广东广州510632 [2]暨南大学附属第一医院肾内科

出　　处：《中国医师杂志》2007年第10期1321-1323,共3页Journal of Chinese Physician

基　　金：国家自然科学基金科学仪器专项资助（30427001） 志谢感谢暨南大学附属第一医院血液净化中心的医生和护士们对本实验的支持和理解!

摘　　要：目的通过观察维持性血液透析患者利用在线尿素清除率（OCM）监测Kt/V的有效性及安全性,为临床提供一种可连续,有效测定透析充分性的方法。方法采用Fresenius4008S透析机和OCM观察28例维持性血液透析患者做动态Kt/V测量,并与透析前后抽血测量的Kt/V值比较。观察患者血压、心率、呼吸变化,及主观症状的变化,观察OCM运行的透析过程的安全性。结果利用OCM测定Kt/V与抽血测量Kt/V相比差异无统计学意义,且两者有直线相关关系;OCM监测的透析过程中患者不良反应发生率与无OCM监测治疗过程相比差异无统计学意义。结论OCM准确地反应透析剂量是相对安全的。临床上可以根据OCM提供的Kt/V值连续观察透析治疗的效果,并及时调整透析方案。Objective To evaluate the efficiency and safety of online clearance measurement （ OCM）＇ and refer a continuous and effective way to assess the hemodialysis adequacy. Method Twenty eight patients with maintenance hemodialysis were enrolled on Fresenius4008S machine and OCM appliance. Meanwhile, plasma Cr and blood urea nitrogen （BUN） of the patient pre - dialysis and post - dialysis were examined Kt/V by OCM. The changes of sodium concentration, blood pressure, heart rate, breathing rate, the subjective symptom between pre - dialysis and post - dialysis, OCM running process and non OCM process were observed. Result There is high correlation between Kt/V by OCM and calculation r = 0.48. The changes of sodium concentration, blood pressure, heart rate, breathing rate, the subjective symptom between pre -dialysis and post -dialysis （ P 〉 0. 05 ）, OCM running process and non OCM process （ P 〉 0. 05 ） had not significant difference. Conclusion The OCM option of hemodialysis machine provides a safety and accurate tool for continuous online monitoring of total urea clearance, which is helpful for adjusting hemodialysis project in time.

关 键 词：尿素/代谢 代谢清除率 

分 类 号：R459.5[医药卫生—治疗学]