重症患者连续性肾脏替代治疗中管路寿命影响因素的研究

Influencing factor on circuit life span in critically ill patients with continuous renal replacement therapy

目的探讨影响重症病患者连续性肾脏替代治疗(CRRT)中管路寿命的因素。方法将131个因为管路凝结而更换配套的滤器分成两组,寿命<48h的为A组(106个),≥48h的为B组(25个)。比较两组管路滤器应用时患者的血清白蛋白、红细胞压积、血小板计数、离子钙浓度、pH值、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、肝素剂量及体温的变化,并采用多因素线性回归对上述指标进行分析。结果 B组患者血清离子钙浓度、pH值及体温明显低于A组患者(P均<0.05)。血PH值及离子钙浓度是影响管路滤器寿命≥48h的相关因素。结论影响CRRT管路寿命≥48h的相关因素是血pH值和离子钙浓度。

Objective To explore the influencing factor of circuit life span in critically ill patients with continuous renal replacement therapy （CRRT）. Methods A total of 131 filters in 32 patients with CRRT were divided into group A （circuit life 〈 48 h, 106 filters） and group B （circuit life ≥48 h, 25 filters）. The levels of serum albumin, hematocrit, platelet, plasma ionized calcium, pH value, activated partial thromboplastin time （APTT）, prothrombin time （PT）, dose of heparin and temperature were recorded and compared. The muhivariate liner regress was used to analyze the correlation factor of circuit life ≥ 48 h. Results The levels of plasma ionized calcium, pH value and temperature in group B were much lower than those in group A （all P 〈 0.05）. The multivariate liner regress analysis showed an association between the circuit life ≥ 48 h and plasma ionized calcium and pH value. Conclusion The plasma ionized calcium and pH value can effect circuit life ≥ 48 h in patients with CRRT.