间歇补充型血液透析滤过及其临床应用

Application of intermittent infusion hemodiafiltration

间歇补充型血液透析滤过(I-HDF),是使用程序化的透析机,在血液透析过程中将高质量的超纯透析液通过透析膜间歇性反超滤输注至血液中,以短期内增加外周循环容量,提高溶质清除率,达到模拟血液透析滤过的效果。I-HDF基本程序:每次输注量为200 ml,每次输注的间隔时间30 min,输注速度为150 ml/min;初次输注在血液透析开始后30 min,并在治疗结束前30 min完成最后一次输注。血液透析时间为4h时,总输注量为1 400 ml(200 ml×7次)。I-HDF可有效改善血液透析治疗过程中患者的外周循环,提高血浆再充盈,增加溶质清除,并且可防止透析膜的渗透性随时间延长而下降,稳定透析中血压,减少心动过速的发生,非常有益于低血压倾向的患者。

Intermittent infusion hemodiafiltration(I-HDF),as a new hemodiafiltration(HDF)method,repeats intermittent infusion during hemodialysis(HD)to temporarily enhance peripheral circulation and improves solute removal efficiency.Purified on-line quality dialysate was intermittently infused by back filtration through the dialysis membrane with a programmed dialysis machine.I-HDF is performed under the following conditions:bolus infusion volume,200 mL;infusion interval,30 min;infusion rate,150 ml/min;total infusion volume,1 400 ml(200 ml×7 times)during treatment time of 4h.I-HDF is effective in improving peripheral circulation during HD,promoting plasma refilling and solute removal,suppressing the reduction in membrane performance over time,stabilizing intradialytic blood pressure,reducing tachycardia and reducing interventions for intradialytic hypotension(IDH).Thus,I-HDF could be beneficial for hypotension-prone patients.