透析液流量对血液透析充分性的影响  

Influence of dialysate flow on the effect of hemodialysis

作　　者：廖淑惠[1] 郑建华[1] 陈兴娅[1] 

机构地区：[1]四川省医学科学院.四川省人民医院血液透析中心,四川成都610072

出　　处：《实用医院临床杂志》2011年第3期93-94,共2页Practical Journal of Clinical Medicine

摘　　要：目的探讨提高透析液流量对血液透析患者透析充分性的影响。方法选择我院长期规律维持性血液透析患者30例,血流量为350-400 ml/min,透析液流量从常规500 ml/min增加至800 ml/min进行13周,其他透析参数（透析时间、血流量、透析器、超滤量）及药物治疗不变。增加透析液流量的前两周及增加后的第12和13周测定透析前后（每周最后一次透析时采集标本）尿素氮、肌酐,并记录每次透析的时间、超滤量、透后体重,再计算出尿素清除指数（Kt/V）和尿素下降率（URR）,取两次测定值的平均值,观察透析液流量对Kt/V和URR的影响。结果透析液流量为800 ml/min时Kt/V值和URR较透析液流量为500 ml/min时有所增加,差异有统计学意义（P〈0.05）。结论透析液流量从500 ml/min增加至800ml/min,可增加Kt/V值和URR,提高血液透析充分性。对于不便增加透析时间和提高血流量的维持性血液透析患者,可增加透析液流量为800 ml/min来提高血液透析充分性。Objective To discuss the influence of dialysate flow on the effect of hemodialysis.Methods We chose 30 patients with long-term regular hemodialysis in our department（blood flow：350-400 ml/min）,and changed the dialysate flow for them from 500 ml/min to 800 ml/min for 13 weeks.Other dialysis parameters（dialysis time,blood flow,dialyzer,ultrafiltration）and medication were unchanged.We tested urea nitrogen,creatinine（collected at the last dialysis of every week）before and after dialysis on the first two weeks before increasing dialysate flow and on the section of 12,13 weeks after increasing dialysate flow,recorded treatment time,ultrafiltration and body weight after dialysis,calculated urea clearance index（Kt/V）and urea reduction ratio,taken the average value of the two measurements,and observed the influence of dialysate flow on Kt/V and urea reduction ratio.Results Kt/V value and urea reduction ratio were increased when dialysate flow raised from 500 ml/min to 800 ml/min.The difference was statistically significant（P0.05）.Conclusions Kt/V values and urea reduction ratio increase and hemodialysis effect enhance as dialysate flow increases from 500 ml/min to 800 ml/min.For patients who were inconvenient to increase duration of dialysis or blood flow volume,it is suggested to improve dialysate flow to 800 ml/min to improve the effect of hemodialysis.

关 键 词：透析液流量 血液透析充分性 尿素清除指数 尿素下降率 

分 类 号：R459.5[医药卫生—治疗学]