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目的:探讨在无抗凝剂连续肾脏替代治疗(CRRT)患者中,间断生理盐水冲洗滤器不同冲洗频率和冲洗量对血液净化效果的影响。方法:便利选取某市三级甲等医院2013年10月至2015年8月住院并行无抗凝剂CRRT的患者240例,按冲洗间隔时间和冲洗量顺次组合为12组,再按患者入院时间依次分配入各组。12组分别为:A组每30 min用100 ml生理盐水冲洗滤器,B组每60 min用100 ml生理盐水冲洗滤器,C组每90 min用100 ml生理盐水冲洗滤器,D组每120 min用100 ml生理盐水冲洗滤器,E组每30 min用150 ml生理盐水冲洗滤器,F组每60 min用150 ml生理盐水冲洗滤器,G组每90 min用150 ml生理盐水冲洗滤器,H组每120 min用150 ml生理盐水冲洗滤器,I组每30 min用200 ml生理盐水冲洗滤器,J组每60 min用200 ml生理盐水冲洗滤器,K组每90 min用200 ml生理盐水冲洗滤器,L组每120 min用200 ml生理盐水冲洗滤器。收集并观察各组血肌酐、尿素氮指标的变化情况。结果:本研究中的不同冲洗频率对血肌酐(P=0.000)和尿素氮(P=0.000)的清除效果有影响,冲洗频率增大,血肌酐和尿素氮下降程度减小。不同冲洗量对血肌酐(P=0.038)和尿素氮(P=0.017)的清除效果有影响,冲洗量增大,血肌酐和尿素氮下降程度减小。结论:无抗凝剂CRRT中的增大生理盐水冲洗滤器的频率与量均降低对血肌酐和尿素氮的清除。
Objective: To investigate the effect of different flushing frequency and flushing volume of intermittent saline flushing filters on blood purification in patients without anticoagulant continuous renal replacement therapy (CRRT). Methods: A total of 240 hospitalized patients with CRRT without anticoagulants who were hospitalized from October 2013 to August 2015 in a city were randomly selected. Groups of 12 patients were randomly divided into 12 groups according to the interval of flushing and the amount of flushing. The time is then assigned to each group. 12 groups were: A group with 100 ml of saline every 30 min rinse the filter, B group every 60 min with 100 ml of saline rinse the filter, C every 90 min rinse the filter with 100 ml of saline, D every 120 min with 100 ml saline flushing filter, group E every 150 minutes with 150 ml saline flush filter, group F every 60 min with 150 ml saline flush filter, group G every 90 min with 150 ml saline flush filter, group H 120 min with 150 ml of saline, group I with 200 ml of saline every 30 min rinse the filter, J group with 60 ml of saline every 60 min rinse the filter, K every 90 min with 200 ml of saline wash the filter, L group Rinse the filter with 200 ml saline every 120 min. Collect and observe the changes of serum creatinine and urea nitrogen index in each group. Results: The different rinsing frequency in this study had an effect on the scavenging effect of serum creatinine (P = 0.000) and urea nitrogen (P = 0.000), the frequency of rinsing increased and the decrease of serum creatinine and urea nitrogen decreased. Different flushing volume affected the scavenging effect of serum creatinine (P = 0.038) and urea nitrogen (P = 0.017), the volume of flushing increased, and the decrease of serum creatinine and urea nitrogen decreased. CONCLUSIONS: The frequency and amount of increased saline flush filter in CRRT without anticoagulant decreased the clearance of serum creatinine and urea nitrogen.