透析器一次性使用和复用的临床研究

Clinical research of the disposable and repeated use of dialyzer

目的:探讨透析器一次性使用和复用对维持性血液透析(MHD)患者的影响。方法:将120例MHD患者按透析器是否复用分为一次性使用组(A,60例)和复用组(B,60例),A组按是否存在传染性疾病分为阳性组(A1,34例)与阴性组(A2,26例)。比较各组尿素清除指数值(Kt/V)、血室容积(TCV)、血红蛋白(HGB)、血白细胞(WBC)、血浆白蛋白(ALB)、C反应蛋白(CRP)、甲状旁腺激素(PTH)等指标及传染性疾病感染率、远期生存率及死亡危险因素的相关分析。结果:各组患者传染性疾病感染率、Kt/V、TCV、PTH、P、Ca2+水平比较均无统计学意义(P>0.05),A组HGB、ALB、WBC水平显著低于B组,透析费用、透析器反应发生率、CRP水平显著高于B组(P均<0.05);A、B组生存率为75%和87%,透析器一次性使用、微炎症状态、贫血是MHD患者死亡的重要危险因素。结论:透析器规范复用能减少透析费用与透析器反应发生率,且不影响透析充分性,也未增加传染性疾病感染率,有可能降低透析患者远期病死率。

of Kt/V, TCV, PTH, P and Ca2＋ were of no statistical differences（P〉0.05） ; HGB, ALB, WBC levels of Group A were significantly lower than those of Group B, while the cost of dialysis, reactions rate of dialyzer, and CRP levels Were significantly higher than those of B group（P〈0.05） the survival rate of Group A and B was 75 % and 87%respectively, and the disposable use of dialyzers, microinflammatory state, and anemia were the important risk factors for the death of MHD patients. Conclusion： The normative repeated use of dialyzer can reduce the cost of dialysis and the occurrence rates of dia sis reaction. Besides, it does not affect the adequacy of dialysis, nor increase the prevalence of infectious diseases, and it may reduce the longterm fatality rate in dialysis patients.