密闭式循环联合超滤预冲在血液透析中的应用效果(1)
摘要：目的 探讨密闭式循环联合超滤预冲在血液透析中的应用。方法 选取我院血透室行维持性血液透析患者75例，每例患者分别采用传统半开放式预冲法和密闭式循环联合模拟超滤法各30次。患者在治疗次数为单数时采用半开放式预冲法，透析例次2250例，设为对照组；患者在治疗次数为双数时采用密闭式循环联合模拟超滤法，透析例次2250例，设为实验组。实验过程中记录管路预冲气泡评分，观察透析器及管路的凝血程度，监测尿素清除指数Kt/V值以及患者的满意度调查。结果 实验组在血液透析充分性Kt/V高于对照组，差异具有统计学意义(t=0.251，P=0.048)；在残余气泡检测上，实验组得分低于对照组，差异具有统计学意义(t=10.826，P=0.017)；实验组与对照组在发生凝血情况的比较差异具有统计学意义(Z=10.639，P=0.002)；在患者满意度方面，差异具有统计学意义(Z=6.302，P=0.009)。结论 密闭式循环联合超滤预冲相比传统半开放式预冲有很大的优越性，降低了透析过程凝血的发生概率，提高了患者透析充分性，得到了患者的满意。
, http://www.100md.com 关键词：密闭式循环预冲；超滤；血液透析
Abstract：Objective To investigate the application of closed circulation combined with ultrafiltration pre-dosing in hemodialysis.Methods In our hospital hemodialysis room for hemodialysis patients 75 cases，all patients were treated with traditional semi open pre washing method and closed cycle simulation combined with ultrafiltration 30 times each.The patients in the treatment of the number of singular semi open pre washing method，dialysis patients 2250 cases as control group；In the treatment of patients with an even number of times，combined with the closed cycle simulation by ultrafiltration，dialysis patients in 2250 cases，as the experimental group.In the course of the experiment recorded the priming bubble score，degree of blood dialyzer and pipeline monitoring observation，urea clearance index Kt/V value and the patient's satisfaction survey.Results The experimental group in the hemodialysis adequacy Kt/V higher than the control group，the difference was statistically significant(t=0.251，P=0.048)；the residual bubble detection，the experimental group was significantly lower than that of the control group，the difference was statistically significant(t=10.826，P=0.017)； the experimental group and control group had significant difference in blood coagulation condition(Z=10.639，P=0.002)；in terms of patient satisfaction， the difference was statistically significant(Z=6.302，P=0.009).Conclusion The closed cycle combined ultrafiltration pre washed compared with traditional semi open preshoots there are great advantages，reduce the probability of occurrence of the dialysis process of coagulation，improve the dialysis adequacy，get the patient's satisfaction.
, 百拇医药
Key words：Closed cycle pre - punching；Ultrafiltration；Hemodialysis
血液透析(Hemodialysis，HD)是終末期肾脏疾病(End stage Renal Disease，ESRD)患者赖以生存的重要治疗方法，更是一项高风险的医疗技术[1]。预冲可以排尽管路和透析器内部的气泡；湿化管路和透析器膜，提高膜对毒素的清除能力；检查管路和透析器是否有泄露；排除体外循环管内的颗粒或致敏物质等，所以进行管路和透析器的预冲是HD治疗前的必要操作。2010版《血液净化标准操作规程》[2]中强调的密闭式预冲在临床上应用广泛，而且取得了很好的效果。自2015年2月以来本科室通过使用宁波天益好密闭式循环管路装置实现连续密闭式循环联合模拟超滤法预冲，取得了满意的效果，即保证了预冲量和预冲时间，也减少了患者上机治疗的等待时间，提高了透析的充分性，降低了患者不良反应的发生率，获得了一致的好评，并于2016年7月推广全科室使用，取缔了半开放式预冲法，现介绍如下。, 百拇医药(林丽君)
, http://www.100md.com 关键词：密闭式循环预冲；超滤；血液透析
Abstract：Objective To investigate the application of closed circulation combined with ultrafiltration pre-dosing in hemodialysis.Methods In our hospital hemodialysis room for hemodialysis patients 75 cases，all patients were treated with traditional semi open pre washing method and closed cycle simulation combined with ultrafiltration 30 times each.The patients in the treatment of the number of singular semi open pre washing method，dialysis patients 2250 cases as control group；In the treatment of patients with an even number of times，combined with the closed cycle simulation by ultrafiltration，dialysis patients in 2250 cases，as the experimental group.In the course of the experiment recorded the priming bubble score，degree of blood dialyzer and pipeline monitoring observation，urea clearance index Kt/V value and the patient's satisfaction survey.Results The experimental group in the hemodialysis adequacy Kt/V higher than the control group，the difference was statistically significant(t=0.251，P=0.048)；the residual bubble detection，the experimental group was significantly lower than that of the control group，the difference was statistically significant(t=10.826，P=0.017)； the experimental group and control group had significant difference in blood coagulation condition(Z=10.639，P=0.002)；in terms of patient satisfaction， the difference was statistically significant(Z=6.302，P=0.009).Conclusion The closed cycle combined ultrafiltration pre washed compared with traditional semi open preshoots there are great advantages，reduce the probability of occurrence of the dialysis process of coagulation，improve the dialysis adequacy，get the patient's satisfaction.
, 百拇医药
Key words：Closed cycle pre - punching；Ultrafiltration；Hemodialysis
血液透析(Hemodialysis，HD)是終末期肾脏疾病(End stage Renal Disease，ESRD)患者赖以生存的重要治疗方法，更是一项高风险的医疗技术[1]。预冲可以排尽管路和透析器内部的气泡；湿化管路和透析器膜，提高膜对毒素的清除能力；检查管路和透析器是否有泄露；排除体外循环管内的颗粒或致敏物质等，所以进行管路和透析器的预冲是HD治疗前的必要操作。2010版《血液净化标准操作规程》[2]中强调的密闭式预冲在临床上应用广泛，而且取得了很好的效果。自2015年2月以来本科室通过使用宁波天益好密闭式循环管路装置实现连续密闭式循环联合模拟超滤法预冲，取得了满意的效果，即保证了预冲量和预冲时间，也减少了患者上机治疗的等待时间，提高了透析的充分性，降低了患者不良反应的发生率，获得了一致的好评，并于2016年7月推广全科室使用，取缔了半开放式预冲法，现介绍如下。, 百拇医药(林丽君)