联机血液透析滤过治疗尿毒症的临床应用研究  

A clinical study on on-line hemodiafiltration in patients with uremia

作　　者：梁萌[1] 关天俊[1] 许树根[1] 黄昭喧[1] 林春华[1] 廖添智[1] 陈振家[1] 王可信[1] 

机构地区：[1]中国人民解放军第174医院肾内科,厦门361003

出　　处：《中国中西医结合肾病杂志》2001年第12期705-707,共3页Chinese Journal of Integrated Traditional and Western Nephrology

摘　　要：目的 :探讨联机血液透析滤过 (On -linehemodiafiltration ,On -lineHDF)对尿毒症患者不同分子量物质的清除率、患者耐受性及临床疗效。方法 :回顾性分析 18例伴有血透并发症及不适症状的尿毒症患者行后稀释法On -lineHDF 2 31例次 ,并与 2 3例仍行常规血液透析 (HD)治疗的患者 (887例次 )进行比较 ,观察Kt/V ,血清肌酐(Scr)、尿素氮 (BUN)、血磷 (SP)、β2 -微球蛋白 (β2 -M )下降率及治疗中患者血透常见并发症和不良反应发生率。结果 :患者对联机HDF治疗效果和耐受性显著优于HD ,透析并发症和不适症状发生率显著低于HD(P <0 .0 1) ,联机HDF治疗后血清Scr、BUN、SP、β2 -M水平显著降低 ,KT/V明显增高。结论 :后稀释法联机HDF能有效清除尿毒症患者血中大、中、小分子物质 ,透析效果显著提高 ,患者对该法治疗的耐受性明显提高 。Objective: To study the clearance of uremic toxins, the tolerance of dialysis and clinical effect of on-line hemodiafiltration (on-line HDF) in patients with uremia. Methods: The KT/V, the clearance of blood urea nitrogen (BUN)?serum creatinine (Scr)?serum phosphate(SP) ?β 2-Microglobulin(β 2-M), rate of dialysis complications in 18 cases of ESRD patienes treated with on-line HDF for 231 times were compared to those with hemodialysis (HD) , 23 cases for 887 times. Results: On-line HDF patients had better tolerance than that of HD, The rate of dialysis complications were much less in on-line HDF patients than that of HD (P<0.01).The clearance of BUN, Scr, SP and β 2-M were better than that of HD . KT/V increases greatly in patients treated with On-line HDF. Conclusion: The clearance of all sizes of uremic toxins were significantly better than that of HD. On-line HDF increases the tolerance to dialysis and significantly improves the effect of dialysis.

关 键 词：尿毒症 联机血液透析滤过 血液透析 透析并发症 

分 类 号：R692.5[医药卫生—泌尿科学] R459.5[医药卫生—外科学]