血液透析面临的问题与挑战  

The problem and challenge faced by hemodialysis

作　　者：孙雪峰[1] 

机构地区：[1]解放军总医院肾脏病科,解放军肾脏病研究所,肾脏疾病国家重点实验室,国家慢性肾病临床医学研究中心,100853

出　　处：《中华肾病研究电子杂志》2015年第3期1-4,共4页Chinese Journal of Kidney Disease Investigation（Electronic Edition）

基　　金：国家自然科学基金面上项目(81270819);"十二五"国家国家科技支撑计划项目(2011BAI10B00)

摘　　要：虽然血液透析应用于临床治疗已经90余年,成为急、慢性肾衰竭的最主要治疗手段,但仍然存在许多问题与挑战。在我国,伴随血液透析患者的快速增加,将给我国医疗保障体系带来严重挑战,亟待加快社会资金参入和培养合格的血液透析医护人员。从血液透析的基本技术层面看,血液透析开始的最佳时机?血管通路是否一定要优先选择血管内瘘?血液透析患者的适宜透析液钙浓度?目前尚存争议。从血液透析并发症防治层面看,透析患者血压控制靶目标?甲状旁腺激素控制的靶目标?目前也无定论。本文将结合现有文献证据进行评述,为临床医生的临床实践提供借鉴。Although hemodialysis has been applied to clinical treatment for more than 90 years and become the main treatment for patients with acute and chronic renal failures, nephrologists are still faced with many problems and challenges. The rapid increase of hemodialysis patients in our country will bring serious challenges to China＇s health care, which is in urgent need of being supported by more social capital participation and cultivation of qualified hemodialysis medical workers. There are still controversies. From the basic technical level of hemodialysis： when is the best time for hemodialysis initiation？ Is intravascular fistula definitely the first choice of vascular access？ What is the suitable calcium concentration of dialysate for hemodialysis patients？ Besides, from the aspect of prevention and treatment of hemodialysis complications in dialysis patients： what is the target of blood pressure control？ How about the target for parathyroid hormone control？ In this article, the existing literature evidence was reviewed in order to provide reference for clinical doctors in clinical practice.

关 键 词：血液透析 血管通路 透析液 并发症 

分 类 号：R459.5[医药卫生—治疗学]