自动压力控制模式在血液透析滤过中的临床应用

Clinical application of automatic pressure control mode to patients with hemodiafiltration

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。

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.