摘要
目的比较2种不同稀释方式在无抗凝剂连续性静脉-静脉血液透析滤过治疗模式下的应用疗效。方法采用前瞻性自身前后对照的研究设计,选择2017年1~12月在四川大学华西医院使用Prismaflex V8.0机器进行连续性静脉-静脉血液透析滤过治疗的20例患者,随机进行前后稀释或后稀释治疗,再进行后稀释与前后稀释治疗。比较前后2组的体外循环寿命。结果治疗过程中患者的凝血功能指标变化无统计学差异(t=0.654,P=0.521),2组模式下平均每小时因静脉压力、动脉压力报警导致血泵暂停的次数无统计学差异(t值分别为0.539,0.705;P值分别为0.232,0.415);后稀释治疗模式下体外循环管路使用寿命平均为(28.80±16.85)h,短于前后稀释治疗模式下体外循环管路使用寿命(40.25±20.32)h,2者比较差异具有统计学意义(t=3.712,P=0.001);2组治疗方式的肌酐、尿素清除效率差异均无统计学意义(t值分别为-0.669,0.030;P值分别为0.512,0.977)。结论前后稀释治疗模式与后稀释治疗模式比较,疗效相当,但前后稀释可以延长体外循环管路及滤器使用寿命,在临床实践中更具有临床意义和价值。
Objective To investigate the effect of two different dilution modes during continuous venovenous hemodiafiltration(CVVHDF).Method Twenty patients who received CVVHDF with PRISMAFLEX V8.0 machine in West China Hospital were randomly assigned to pre-and post-dilution or total post-dilution,and then crossed over with each other.The life span of extracorporeal circuit and other performance metrics were compared between the two groups.Result During the treatment,there were no statistically significant differences in the changes of coagulation function indicators(t=0.654,P=0.521).There was no statistically significant difference in the frequency of blood pump suspension caused by alarm of venous pressure(t=0.539,P=0.232)and arterial pressure(t=0.705,P=0.415)per hour between the two groups.The average service life of extracorporeal circulation pipeline in the post-dilution treatment mode was 28.80±16.85 h,which was shorter than 40.25±20.32 h in the post-dilution treatment mode,and the difference was statistically significant(t=3.712,P=0.001).There were no statistically significant differences in the clearance efficiency of creatinine(t=-0.669,P=0.512)and urea(t=0.030,P=0.977)between the two groups.Conclusion Compared with post-dilution mode,pre-and post-dilution can effectively prolong the life-span of extracorporeal circuit during CVVHDF,and should be recommended in clinical practice.
作者
张敏
段棣飞
张凌
王芳
陈志文
李旭
ZHANG Min;DUAN Li-fei;ZHANG Ling;WANG Fang;CHEN Zhi-wen;LI Xu(Department of Nephrology,West China Hospital of Sichuan University,Chengdu 610041,China)
出处
《中国血液净化》
CSCD
2019年第12期822-825,共4页
Chinese Journal of Blood Purification
关键词
连续性静脉-静脉血液滤过透析
前后稀释
后稀释
滤器寿命
Continuous veno-venous hemodiafiltration
Pre-and post-dilution
Post-dilution
Life span of extracorporeal circuit
