中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (05): 286-288.

• 临床研究 • 上一篇    下一篇

自动压力控制模式在血液透析滤过中的临床应用

尹佳宁,封素娟,李寒,王世相   

  1. 首都医科大学附属北京朝阳医院血液净化科
  • 收稿日期:2014-11-14 修回日期:2015-02-07 出版日期:2015-05-12 发布日期:2015-05-29
  • 通讯作者: 李寒 hanli@ccmu.edu.cn E-mail:hanli@ccmu.edu.cn

Clinical Application of Automatic Pressure Control Mode to Patients with Hemodiafiltration

  • Received:2014-11-14 Revised:2015-02-07 Online:2015-05-12 Published:2015-05-29

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摘要： 【摘要】目的探讨自动压力控制模式在血液透析滤过中的应用效果。方法入选70 例维持性血液透析患者，每2 周行血液透析滤过1 次，后稀释法输注置换液，给予传统容量控制补液模式6 次和自动压力控制补液模式6 次，自身交叉对照，观察不同模式下的置换液量、Duo 瘙痒评分、高压报警次数及凝血情况。结果自动压力控制模式置换液量比传统容量控制模式显著增加(16.1±1.8L 比13.5±1.4L, t=14.49,P＜0.001)；Duo 瘙痒评分明显降低(12.3±1.0 比16.1±2.2,t =-13.57,P＜0.001)；高压报警发生率显著降低(0 比15.47%,P＜0.001)；透析器及管路凝血发生率显著下降(0 比2.6%，P＜0.001)。结论自动压力控制模式的血液透析滤过可增加置换液量，降低凝血风险，改善患者瘙痒症状。

关键词: 血液透析滤过, 压力控制, 后稀释, 瘙痒

Abstract: 【Abstract】Objective To investigate the effect of the automatic pressure control mode on patients with hemodiafiltration. Methods We enrolled 70 maintenance hemodialysis patients in a single hemodialysis center for this study. They were treated with hemodiafiltration once every two weeks. The volume control mode
for 6 times and automatic pressure control mode for 6 times were used sequentially. Duo pruritus score, the times of high pressure alarm and coagulation were recorded and compared by setting a self crossover control group during treatment. Results The volume of convection was significantly higher in automatic pressure control mode than in volume control mode (16.1±1.8L vs. 13.5±1.4L, t =14.49, P＜0.001). Duo pruritus score was significantly reduced (12.3±1.0 vs. 16.1±2.2, t =-13.57, P＜0.001). The times of high pressure alarm were lower in automatic pressure control mode than in volume control mode (0% vs. 15.47%; P＜0.001). The incidence of coagulation in dialyzer and dialysis tubing were significantly reduced (0 vs. 2.1%, P＜0.001). Conclusions Automatic pressure control mode can increase the amount of convection in hemodiafiltration, reduce the risk of blood clotting, and relieve pruritus symptom.

Key words: hemodiafiltration, pressure control, post-dilution, pruritu