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在线清除监测在评价血透患者透析剂量中的应用 被引量:12

Application of on-line clearance monitoring in evaluating Kt/V of dialysis patients
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摘要 目的探讨在线清除监测(on-line clearance monitor,OCM)评价血液透析充分性的临床实用价值。方法80例维持性血液透析患者同时应用OCM和常规取血法测定尿素清除指数(Kt/V),对两者的相关性进行评价。结果OCM测定的Kt/V(Kt/Vm)=1.18±0.25,取血法计算的Kt/V(Kt/Vc)=1.45±0.19,二者相关性良好(r=0.942,P<0.001)。同一患者的Kt/Vm较Kt/Vc低0.19±0.11(P<0.001)。Kt/Vc与身高及干体重负相关(r=-0.533和-0.485,P<0.001),与透析超滤量正相关(r=0.331,P=0.008)。通过OCM调整透析处方,短期内即可纠正透析剂量不足。结论应用OCM测定Kt/V,可即时、方便、准确地反映尿素清除效率,有利于分析透析剂量不足的原因并及时调整透析处方,很有临床实用价值。 Objective To investigate the value of on- line clearance monitor (OCM) in evaluat- ing dialysis adequacy of hemodialysis patients. Methods In 80 hemodialysis patients, Kt/V was determined by OCM(Kt/Vm) and conventional calculated method on kinetic models(Kt/Vc) at the same time. Results (1) Kt/Vm detected by OCM was 1.18±0.25, which was close correlated with Kt/ Vc (r = 0. 942, P〈0. 001). (2) Kt/Vc was also correlated with the height and dry weight of patients and the ultrafiltration volume ( r = - 0. 533, - 0. 485 and 0.331, P 〈 0.01). (3) The prescription of dialysis was adjusted based on the results of OCM and adequate dialysis was achieved in several sessions. Conclusion OCM can display the Kt/V data rapidly, timely and accurately. It is very useful in monitoring the adequacy of dialysis and helping doctors to achieve the optimal prescription as soon as possible.
出处 《中国医师进修杂志(内科版)》 2006年第4期40-43,共4页 Chinese Journal of Postgraduates of Medicine
关键词 尿素清除指数 透析充分性 在线清除监测 Urea clearance index Adequacy of dialysis On- line clearance monitor
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参考文献7

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