{"id":32580,"date":"2024-05-06T04:01:46","date_gmt":"2024-05-06T04:01:46","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=32580"},"modified":"2024-05-06T04:01:46","modified_gmt":"2024-05-06T04:01:46","slug":"%e8%a1%80%e6%b6%b2%e9%80%8f%e6%9e%90%e6%bb%a4%e8%bf%87%e8%b4%a8%e9%87%8f%e6%8e%a7%e5%88%b6%e4%b8%b4%e5%ba%8a%e5%ae%9e%e8%b7%b5%e6%8c%87%e5%8d%97%ef%bc%882024%ef%bc%89","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=32580","title":{"rendered":"\u8840\u6db2\u900f\u6790\u6ee4\u8fc7\u8d28\u91cf\u63a7\u5236\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\uff082024\uff09"},"content":{"rendered":"

\u80be\u75c5\u900f\u6790\u6307\u5357\u901f\u9012<\/p>\n

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\u63a8\u8350\u610f\u89c11\uff1a\u63a8\u8350HDF\u7528\u4e8e\u7ec8\u672b\u671f\u80be\u75c5\u60a3\u8005\u7684\u7ef4\u6301\u6027\u900f\u6790\u6cbb\u7597\u3002\uff08A1a\uff09<\/p>\n

\u8d8a\u6765\u8d8a\u591a\u7684\u8bc1\u636e\u663e\u793a\u4e0e\u8840\u6db2\u900f\u6790\u6bd4\u8f83\uff0c\u9ad8\u5bb9\u91cfHDF\u80fd\u6709\u6548\u6539\u5584\u60a3\u8005\u957f\u671f\u751f\u5b58\uff0c\u51cf\u5c11\u5fc3\u8840\u7ba1\u4e8b\u4ef6\u53d1\u751f\uff0c\u5e76\u4e14\u5177\u6709\u826f\u597d\u7684\u5b89\u5168\u6027\u3002\u900f\u6790\u7ed3\u679c\u548c\u5b9e\u8df5\u6a21\u5f0f\u7814\u7a76\uff08Dialysis Outcomes and Practice Patterns Study\uff0cDOPPS\uff09\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u4f4e\u901a\u91cf\u8840\u6db2\u900f\u6790\u6bd4\u8f83\uff0c\u9ad8\u5bb9\u91cfHDF\uff08\u7f6e\u6362\u6db215~25 L\/\u6b21\uff09\u51cf\u5c11\u60a3\u8005\u5168\u56e0\u6b7b\u4ea1\u738735%\uff3b14\uff3d<\/sup>\u3002\u6700\u5177\u4ee3\u8868\u6027\u7684\u6b27\u6d324\u9879\u524d\u77bb\u6027\u3001\u968f\u673a\u5bf9\u7167\u7814\u7a76\u4e2d\uff0c\u867d\u7136714\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u6bd4\u8f83on-line HDF\u4e0e\u4f4e\u901a\u91cf\u8840\u6db2\u900f\u6790\u7684\u5168\u56e0\u6b7b\u4ea1\u548c\u5fc3\u8840\u7ba1\u9884\u540e\uff08CONTRAST\uff09\u7814\u7a76\u548c782\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u6bd4\u8f83on-line HDF\u4e0e\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u7684\u5168\u56e0\u6b7b\u4ea1\u548c\u5fc3\u8840\u7ba1\u4e8b\u4ef6\uff08TURKISH\uff09\u7814\u7a76\u7684\u521d\u59cb\u5206\u6790\u5747\u672a\u53d1\u73b0HDF\u6cbb\u7597\u8f83\u8840\u6db2\u900f\u6790\u51cf\u5c11\u60a3\u8005\u7684\u6b7b\u4ea1\u98ce\u9669\uff0c\u4f46\u4e9a\u7ec4\u5206\u6790\u663e\u793a\uff0c\u5f53\u7f6e\u6362\u6db2\u91cf\u226522 L\/\u6b21\u65f6\uff0c2\u9879\u7814\u7a76\u5747\u663e\u793a\u663e\u8457\u7684\u60a3\u8005\u751f\u5b58\u83b7\u76ca\uff3b3, 4\uff3d<\/sup>\u3002906\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u6bd4\u8f83on-line HDF\u4e0e\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u7684\u5168\u56e0\u6b7b\u4ea1\uff08ESHOL\uff09\u7814\u7a76\u4e2d\uff0cHDF\u6cbb\u7597\u60a3\u8005\u7684\u5e73\u5747\u5bf9\u6d41\u91cf\u8fbe\u523022.9~23.9 L\/\u6b21\uff0c\u5176\u5168\u56e0\u6b7b\u4ea1\u7387\u548c\u5fc3\u8840\u7ba1\u75c5\u6b7b\u4ea1\u7387\u5747\u8f83\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u60a3\u8005\u4e0b\u964d30%\uff1b\u5e76\u4e14HDF\u7ec4\u7684\u4f4e\u8840\u538b\u4e8b\u4ef6\u3001\u8111\u5352\u4e2d\u53ca\u611f\u67d3\u7684\u53d1\u751f\u7387\u5206\u522b\u4e0b\u964d\u4e8628%\u300161%\u548c55%\uff3b5\uff3d<\/sup>\u3002FRENCHIE\u7814\u7a76\u662f\u572865\u5c81\u4ee5\u4e0a\u7ec8\u672b\u671f\u80be\u75c5\u60a3\u8005\u4e2d\u8fdb\u884c\u7684\uff0c\u91cd\u70b9\u5173\u6ce8\u4e86HDF\u7684\u5b89\u5168\u6027\uff0c\u7ed3\u679c\u53d1\u73b0HDF\u8f83\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u60a3\u8005\u53d1\u751f\u900f\u6790\u4f4e\u8840\u538b\u3001\u808c\u8089\u75c9\u631b\u7684\u6bd4\u4f8b\u660e\u663e\u51cf\u5c11\uff3b6\uff3d<\/sup>\u3002\u57fa\u4e8e\u4ee5\u4e0a4\u9879\u968f\u673a\u5bf9\u7167\u7814\u7a762 793\u4f8b\u60a3\u8005\u4e2a\u4f53\u6570\u636e\u7684\u6c47\u603b\u5206\u6790\u4e2d\uff0c\u5728\u5e73\u57472.5\u5e74\u7684\u968f\u8bbf\u4e2d\u51fa\u73b0769\u4f8b\u6b7b\u4ea1\uff08\u5176\u4e2d292\u4f8b\u6b7b\u4e8e\u5fc3\u8840\u7ba1\u4e8b\u4ef6\uff09\uff1b\u7ed3\u679c\u5206\u6790\u53d1\u73b0\u7f6e\u6362\u6db2\u91cf>23 L\/1.73 m2<\/sup>\u4f53\u8868\u9762\u79ef\u65f6\uff0cHDF\u7ec4\u8f83\u8840\u6db2\u900f\u6790\u7ec4\u7684\u5168\u56e0\u6b7b\u4ea1\u548c\u5fc3\u8840\u7ba1\u75c5\u6b7b\u4ea1\u98ce\u9669\u5206\u522b\u4e0b\u964d22%\u548c31%\uff3b15\uff3d<\/sup>\u3002<\/p>\n

\u63a8\u8350\u610f\u89c12\uff1a\u63a8\u8350\u5408\u5e76\u4ee5\u4e0b\u5e76\u53d1\u75c7\u7684\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u4f18\u5148\u9009\u62e9HDF\u6cbb\u7597\uff0c\u5305\u62ec\uff1a\uff081\uff09\u53cd\u590d\u900f\u6790\u4f4e\u8840\u538b\uff08A1b\uff09\uff1b\uff082\uff09\u5408\u5e76\u5fc3\u810f\u75be\u75c5\uff08A1a\uff09\uff1b\uff083\uff09\u9ad8\u03b22-\u5fae\u7403\u86cb\u767d\u8840\u75c7\u53ca\u900f\u6790\u76f8\u5173\u6dc0\u7c89\u6837\u53d8\u6027\uff08A1a\uff09\uff1b\uff084\uff09\u708e\u75c7\/\u5fae\u708e\u75c7\u72b6\u6001\uff08B2b\uff09\uff1b\uff085\uff09\u4fc3\u7ea2\u7ec6\u80de\u751f\u6210\u7d20\u6cbb\u7597\u53cd\u5e94\u4e0d\u4f73\u7684\u80be\u6027\u8d2b\u8840\uff08B2b\uff09\uff1b\uff086\uff09\u8425\u517b\u4e0d\u826f\/\u86cb\u767d\u80fd\u91cf\u6d88\u8017\uff08B2b\uff09\uff1b\uff087\uff09\u4e0d\u5b81\u817f\u7efc\u5408\u5f81\uff08C4\uff09\u3002<\/p>\n

\u4e00\u7bc7\u9488\u5bf935\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c4 039\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u8840\u6db2\u900f\u6790\u6bd4\u8f83\uff0cHDF\u6216HF\u663e\u8457\u964d\u4f4e\u900f\u6790\u671f\u95f4\u4f4e\u8840\u538b\u7684\u53d1\u751f\u7387\uff08RR=0.72\uff0c95%CI\uff1a0.66~0.80\uff09\u548c\u5fc3\u8840\u7ba1\u75c5\u6b7b\u4ea1\u7387\uff08RR=0.75\uff0c95%CI\uff1a0.58~0.97\uff0cI2<\/sup>=0\uff09\u4ee5\u53ca\u900f\u6790\u524d\u03b22-\u5fae\u7403\u86cb\u767d\u6c34\u5e73\uff3b\u5e73\u5747\u5dee\u503c\uff08MD\uff09=-5.77 mg\/dl\uff0c95%CI\uff1a-10.97~-0.56\uff0cI2<\/sup>=94%\uff3d\uff0c\u5e76\u63d0\u9ad8\u900f\u6790\u5145\u5206\u6027\uff3b\u5c3f\u7d20\u6e05\u9664\u6307\u6570\uff08Kt\/V\uff09\u7684MD=0.10\uff0c95%CI\uff1a0.02~0.19\uff0cI2<\/sup>=85%\uff3d\uff1b\u4f46\u5168\u56e0\u6b7b\u4ea1\u7387\u3001\u975e\u81f4\u547d\u6027\u5fc3\u8840\u7ba1\u4e8b\u4ef6\u548c\u4f4f\u9662\u6cbb\u7597\u7387\u65e0\u660e\u663e\u5dee\u522b\uff3b1\uff3d<\/sup>\u3002\u53e6\u4e00\u7bc7\u57fa\u4e8e65\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff0829\u9879\u4ea4\u53c9\u8bd5\u9a8c\u548c36\u9879\u5e73\u884c\u81c2\u8bd5\u9a8c\uff0912 182\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u4f4e\u901a\u91cf\u8840\u6db2\u900f\u6790\u6bd4\u8f83\uff0cHDF\/HF\u663e\u8457\u964d\u4f4e\u900f\u6790\u76f8\u5173\u4f4e\u8840\u538b\uff08RR=0.55\uff0c95%CI\uff1a0.35~0.87\uff0cI2<\/sup>=99%\uff09\u548c\u5fc3\u8840\u7ba1\u75c5\u6b7b\u4ea1\u7387\uff08RR=0.84\uff0c95%CI\uff1a0.71~0.98\uff0cI2<\/sup>=0\uff09\uff0c\u5168\u56e0\u6b7b\u4ea1\u7387\u548c\u5168\u56e0\u4f4f\u9662\u7387\u65e0\u660e\u663e\u5dee\u522b\uff1b\u663e\u8457\u589e\u52a0\u03b22-\u5fae\u7403\u86cb\u767d\u6e05\u9664\u7387\uff08MD=64.8 ml\/min\uff0c95%CI\uff1a46.8~82.8\uff09\u548c\u964d\u4f4e\u8840\u6e05\u03b22-\u5fae\u7403\u86cb\u767d\u6c34\u5e73\uff08MD=-9.94 mg\/dl\uff0c95%Cl\uff1a-12.42~-7.46\uff09\uff3b16\uff3d<\/sup>\u3002<\/p>\n

\u57fa\u4e8e4\u9879\u6bd4\u8f83\u8840\u6db2\u900f\u6790\u548c\u540e\u7a00\u91caon-line HDF\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u60a3\u8005\u4e2a\u4f53\u6570\u636e\u7684\u5177\u4f53\u6b7b\u4ea1\u75c5\u56e0\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u5e73\u5747\u968f\u8bbf2.5\u5e74\u671f\u95f4on-line HDF\uff08\u5e73\u5747\u7f6e\u6362\u6db2\u91cf22 L\/\u6b21\uff09\u8f83\u8840\u6db2\u900f\u6790\u663e\u8457\u51cf\u5c11\u5168\u56e0\u6b7b\u4ea1\uff08HR=0.86\uff0c95%CI\uff1a0.75~0.99\uff09\u3001\u5fc3\u810f\u75be\u75c5\u6b7b\u4ea1\uff08HR=0.64\uff0c95%CI\uff1a0.45~0.90\uff09\u548c\u5305\u62ec\u731d\u6b7b\u7684\u5fc3\u8840\u7ba1\u75be\u75c5\u6b7b\u4ea1\uff08HR=0.81\uff0c95%CI\uff1a0.65~1.00\uff09\uff1b\u5176\u4e2d\u51cf\u5c11\u7684\u5168\u56e0\u6b7b\u4ea171%\u7684\u75c5\u4f8b\u6765\u6e90\u4e8e\u51cf\u5c11\u5fc3\u8840\u7ba1\u75be\u75c5\u6b7b\u4ea1\u75c5\u4f8b\uff0c\u51cf\u5c11\u7684\u5fc3\u8840\u7ba1\u75be\u75c5\u6b7b\u4ea173%\u7684\u75c5\u4f8b\u6765\u6e90\u4e8e\u51cf\u5c11\u5fc3\u810f\u75be\u75c5\u6b7b\u4ea1\u75c5\u4f8b\uff1bon-line HDF\u8f83\u8840\u6db2\u900f\u6790\u663e\u8457\u51cf\u5c11\u5168\u90e8\u5fc3\u810f\u4e8b\u4ef6\uff08HR=0.64\uff0c95%CI\uff1a0.45~0.90\uff09\u4ee5\u53ca\u5fc3\u808c\u6897\u6b7b\u6216\u5fc3\u5f8b\u5931\u5e38\uff08HR=0.58\uff0c95%CI\uff1a0.36~0.91\uff09\u7684\u53d1\u751f\uff3b17\uff3d<\/sup>\u300210\u4f8b\u5931\u4ee3\u507f\u6027\u5145\u8840\u6027\u5fc3\u529b\u8870\u7aed\uff3b\u7ebd\u7ea6\u5fc3\u810f\u75c5\u534f\u4f1a\uff08NYHA\uff09\u2162~\u2163\u7ea7\uff3d\u60a3\u8005\u524d\u77bb\u6027\u5bf9\u7167\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0cHDF\u4e0e\u544b\u585e\u7c73\u6cbb\u7597\u5747\u53ef\u663e\u8457\u51cf\u5c11\u4f53\u91cd\u548c\u8840\u6e05\u8111\u94a0\u80bd\u6c34\u5e73\uff1b\u4f46HDF\u6cbb\u7597\u540e\u8840\u6e05\u767d\u7ec6\u80de\u4ecb\u7d20\uff08IL\uff09-8\uff3b\uff0830.7\u00b125.1\uff09\u6bd4\uff0845.6\u00b148.3\uff09pg\/ml\uff0cP<0.05\uff3d\u548c\u5355\u6838\u7ec6\u80de\u8d8b\u5316\u86cb\u767d-1\uff3b\uff082.3\u00b10.3\uff09\u6bd4\uff0810.9\u00b14.5\uff09pg\/ml\uff0cP<0.05\uff3d\u6c34\u5e73\u663e\u8457\u964d\u4f4e\uff0c\u544b\u585e\u7c73\u5242\u91cf\u663e\u8457\u51cf\u5c11\uff3b\uff0875\u00b138\uff09\u6bd4\uff08180\u00b180\uff09mg\/d\uff0cP<0.05\uff3d\uff0c\u800c\u9759\u8109\u6ce8\u5c04\u544b\u585e\u7c73\u540e\u5747\u65e0\u660e\u663e\u53d8\u5316\uff1b\u63d0\u793aHDF\u53ef\u6709\u6548\u964d\u4f4e\u665a\u671f\u5145\u8840\u6027\u5fc3\u529b\u8870\u7aed\u60a3\u8005\u7684\u5faa\u73af\u8111\u94a0\u80bd\u6c34\u5e73\u548c\u7ec6\u80de\u56e0\u5b50\u6c34\u5e73\uff0c\u6062\u590d\u544b\u585e\u7c73\u6cbb\u7597\u53cd\u5e94\u6027\uff3b18\uff3d<\/sup>\u3002<\/p>\n

45\u4f8b\u6bcf\u54683\u6b21\u8840\u6db2\u900f\u6790\u22652\u4e2a\u6708\u60a3\u8005\u7684\u524d\u77bb\u6027\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u663e\u793a\uff0c\u540e\u7a00\u91caon-line HDF\uff3b\u8d85\u6ee4\u91cf\uff0821\u00b11\uff09L\/\u6b21\uff3d\u8f83\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u80fd\u66f4\u6709\u6548\u6e05\u9664\u03b22-\u5fae\u7403\u86cb\u767d\uff08\u6cbb\u7597\u524d\u540e\u53d8\u5316\u738773%\u6bd458%\uff09\uff0c\u900f\u6790\u524d\u03b22-\u5fae\u7403\u86cb\u767d\u6d53\u5ea6\u5728\u968f\u8bbf1\u5e74\u4e2d\u9010\u6e10\u4e0b\u964d\uff0c\u4e14\u5728HDF\u6cbb\u7597\u7ec4\u4e2d\u4e0b\u964d\u66f4\u4e3a\u660e\u663e\uff3b19\uff3d<\/sup>\u300269\u9879\u4e34\u5e8a\u7814\u7a761 879\u4f8b\u60a3\u8005\u76846 771\u4e2a\u6d4b\u91cf\u6570\u636e\u7684\u968f\u673a\u6548\u5e94\u835f\u8403\u5206\u6790\u548c\u835f\u8403\u56de\u5f52\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0cHDF\/HF\u7684\u5e73\u5747\u03b22-\u5fae\u7403\u86cb\u767d\u6e05\u9664\u7387\u663e\u8457\u9ad8\u4e8e\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\uff0887.06\u6bd448.75 ml\/min\uff09\uff0c\u900f\u6790\u819c\u6210\u5206\u4e0e\u7279\u6027\u3001\u51c0\u5316\u65b9\u5f0f\uff08\u5f25\u6563\u6216\u5bf9\u6d41\uff09\u3001\u8840\u6d41\u91cf\u548c\u7f6e\u6362\u6db2\u91cf\u7b49\u662f\u5f71\u54cd\u03b22-\u5fae\u7403\u86cb\u767d\u6e05\u9664\u7684\u5173\u952e\u56e0\u7d20\uff3b20\uff3d<\/sup>\u30026 444\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u524d\u77bb\u6027\u89c2\u5bdf\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u8840\u6db2\u900f\u6790\u60a3\u8005\u6bd4\u8f83\uff0c\u6821\u6b63\u5e74\u9f84\u548c\u7cd6\u5c3f\u75c5\u540eHDF\/HF\u60a3\u8005\u9700\u8981\u8155\u7ba1\u7efc\u5408\u5f81\u624b\u672f\u98ce\u9669\u964d\u4f4e42%\uff0c\u8c03\u6574\u5e74\u9f84\u3001\u6027\u522b\u548c\u5408\u5e76\u75c7\u540eHDF\/HF\u60a3\u8005\u7684\u6b7b\u4ea1\u98ce\u9669\u964d\u4f4e10%\uff3b21\uff3d<\/sup>\u30021 196\u4f8b\u65e5\u672c\u900f\u6790\u6cbb\u7597\u534f\u4f1a\u767b\u8bb0\u60a3\u8005\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u900f\u6790\u76f8\u5173\u6dc0\u7c89\u6837\u53d8\u6027\u6cbb\u7597\u6548\u679c\u8f83\u5dee\u7684\u98ce\u9669\u4ee5\u4f4e\u901a\u91cf\u8840\u6db2\u900f\u6790\u4e3a1.0\u65f6\uff0c\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u7684\u98ce\u9669\u4e3a0.489\uff0c\u975e\u8054\u673aHDF\u98ce\u9669\u4e3a0.117\uff0con-line HDF\u7684\u98ce\u9669\u4e3a0.013\uff0c\u63a8\u62c9\u5f0fHDF\u98ce\u9669\u4e3a0.017\uff0c\u8054\u5408\u5e94\u7528\u03b22-\u5fae\u7403\u86cb\u767d\u5438\u9644\u67f1\u7684\u8840\u6db2\u900f\u6790\u98ce\u9669\u4e3a0.054\uff3b22\uff3d<\/sup>\u3002<\/p>\n

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\u4fc3\u7ea2\u7ec6\u80de\u751f\u6210\u7d20\u4f4e\u53cd\u5e94\u5728\u7ef4\u6301\u6027\u900f\u6790\u60a3\u8005\u4e2d\u5e76\u4e0d\u5c11\u89c1\uff0c\u786e\u5207\u673a\u5236\u4e0d\u660e\u300222\u4e2a\u56fd\u5bb6560\u4e2a\u900f\u6790\u4e2d\u5fc3\u7684\u56de\u987e\u6027\u7814\u7a76\u4e2d\uff0c\u503e\u5411\u8bc4\u5206\u5339\u914d\u540e\u5e73\u5747\u968f\u8bbf1.3\u5e74\u7684on-line HDF\u4e0e\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u60a3\u8005\u54043 373\u4f8b\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u6bd4\u8f83\uff0con-line HDF\u7ec4\u7684\u4fc3\u7ea2\u7ec6\u80de\u751f\u6210\u7d20\u62b5\u6297\u6307\u6570\u4e0b\u964d\u66f4\u5feb\uff0c\u4fc3\u7ea2\u7ec6\u80de\u751f\u6210\u7d20\u4f7f\u7528\u5242\u91cf\u51cf\u5c11\u66f4\u591a\uff0c\u8840\u7ea2\u86cb\u767d\u6c34\u5e73\u66f4\u9ad8\uff3b27\uff3d<\/sup>\u3002\u89c2\u5bdf\u6027\u7814\u7a76\u4e5f\u8bc1\u660eon-line HDF\u80fd\u66f4\u6709\u6548\u5730\u6539\u5584\u80be\u6027\u8d2b\u8840\uff0c\u51cf\u5c11\u4fc3\u7ea2\u7ec6\u80de\u751f\u6210\u7d20\u4f7f\u7528\u5242\u91cf\uff0c\u53ef\u80fd\u4e0e\u5176\u6539\u5584\u60a3\u8005\u5fae\u708e\u75c7\u72b6\u6001\u3001\u4fc3\u8fdb\u94c1\u5229\u7528\u7b49\u76f8\u5173\uff3b28, 29\uff3d<\/sup>\u3002<\/p>\n

\u8425\u517b\u4e0d\u826f\/\u86cb\u767d\u80fd\u91cf\u6d88\u8017\uff08protein-energy wasting\uff0cPEW\uff09\u4e0e\u900f\u6790\u60a3\u8005\u7684\u6b7b\u4ea1\u98ce\u9669\u5bc6\u5207\u76f8\u5173\u3002\u4e00\u987933\u4f8b\u7ef4\u6301\u6027\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u524d\u77bb\u6027\u3001\u5f00\u653e\u6807\u7b7e\u5bf9\u7167\u7814\u7a76\u663e\u793a\uff0c\u968f\u8bbf12\u4e2a\u6708\u540eon-line HDF\u7ec4\u60a3\u8005\u8f83\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u60a3\u8005\u80fd\u6709\u6548\u4fdd\u6301\u808c\u8089\u91cf\uff0c\u589e\u52a0\u86cb\u767d\u6444\u5165\uff0c\u51cf\u5c11\u708e\u75c7\u72b6\u6001\uff0c\u4ece\u800c\u7ef4\u6301\u66f4\u597d\u7684\u8425\u517b\u72b6\u51b5\uff0c\u6539\u5584PEW\uff3b30\uff3d<\/sup>\u3002on-line HDF\u4e0e\u8840\u6db2\u900f\u6790\u60a3\u8005\u540410\u4f8b\u7684\u89c2\u5bdf\u6027\u7814\u7a76\u4e2d\uff0c\u5f53\u8fbe\u5230\u76f8\u540cKt\/V\u65f6\uff0c\u524d\u7a00\u91caon-line HDF\u8f83\u8840\u6db2\u900f\u6790\u60a3\u8005\u635f\u5931\u7684\u8c37\u6c28\u9170\u80fa\u548c\u7cbe\u6c28\u9178\u4ee5\u53ca\u975e\u5fc5\u9700\u6c28\u57fa\u9178\u663e\u8457\u51cf\u5c11\uff0c\u53ef\u4f7f\u60a3\u8005\u7ef4\u6301\u66f4\u597d\u7684\u8425\u517b\u72b6\u6001\uff3b31\uff3d<\/sup>\u3002<\/p>\n

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\u76ee\u7684\u662f\u8bc4\u4f30\u6cbb\u7597\u6548\u679c\uff0c\u53ca\u65f6\u8c03\u6574\u6cbb\u7597\u65b9\u6848\uff0c\u5efa\u8bae\u5b9a\u671f\u76d1\u6d4b\u8bc4\u4f30\u4ee5\u4e0b\u6307\u6807\u3002<\/p>\n

1. \u8840\u5e38\u89c4\u3001\u8840\u808c\u9150\u3001\u8840\u5c3f\u7d20\u6c2e\u53ca\u8840\u6e05\u7535\u89e3\u8d28\uff1a\u6bcf1~3\u4e2a\u6708\u68c0\u67e51\u6b21\u900f\u6790\u524d\u8840\u5e38\u89c4\u3001\u8840\u808c\u9150\u3001\u8840\u5c3f\u7d20\u6c2e\u53ca\u8840\u6e05\u7535\u89e3\u8d28\uff3b\u94be\u3001\u94a0\u3001\u6c2f\u3001\u9499\u3001\u78f7\u3001HCO3<\/sub>-\u6216\u4e8c\u6c27\u5316\u78b3\u7ed3\u5408\u529b\uff08CO2<\/sub>CP\uff09\u7b49\uff3d\u3002\u5728\u8d2b\u8840\u6cbb\u7597\u7684\u5f00\u59cb\u9636\u6bb5\u3001\u65b9\u6848\u8c03\u6574\u9636\u6bb5\u4ee5\u53ca\u75c5\u60c5\u4e0d\u7a33\u5b9a\u65f6\uff0c\u5e94\u589e\u52a0\u76d1\u6d4b\u9891\u7387\uff0c\u53ca\u65f6\u8c03\u6574\u6cbb\u7597\u65b9\u6848\u3002<\/p>\n

2. \u94c1\u4ee3\u8c22\u6307\u6807\uff1a\u6bcf3~6\u4e2a\u6708\u68c0\u6d4b1\u6b21\u94c1\u4ee3\u8c22\u6307\u6807\uff0c\u5305\u62ec\u8840\u6e05\u94c1\u86cb\u767d\u3001\u8f6c\u94c1\u86cb\u767d\u9971\u548c\u5ea6\u7b49\uff1b\u94c1\u5242\u6cbb\u7597\u671f\u95f4\u9700\u589e\u52a0\u68c0\u6d4b\u9891\u7387\uff0c\u4ee5\u4fbf\u8bc4\u4f30\u7597\u6548\uff0c\u8c03\u6574\u65b9\u6848\u3002<\/p>\n

3. \u8840\u6e05\u7532\u72b6\u65c1\u817a\u6fc0\u7d20\uff1a\u6bcf3~6\u4e2a\u6708\u68c0\u6d4b1\u6b21\u8840\u6e05\u7532\u72b6\u65c1\u817a\u6fc0\u7d20\uff0c\u6839\u636e\u60a3\u8005\u63a5\u53d7\u836f\u7269\u7684\u60c5\u51b5\u76f8\u5e94\u589e\u52a0\u68c0\u6d4b\u9891\u7387\u3002<\/p>\n

4. \u8425\u517b\u8bc4\u4f30\u548c\u708e\u75c7\u72b6\u6001\u8bc4\u4f30\uff1a\u6bcf3~6\u4e2a\u67081\u6b21\u8fdb\u884c\u8425\u517b\u8bc4\u4f30\u548c\u708e\u75c7\u72b6\u6001\u8bc4\u4f30\uff0c\u5305\u62ec\u8840\u6e05\u8425\u517b\u5b66\u6307\u6807\u3001\u9ad8\u654fC\u53cd\u5e94\u86cb\u767d\u3001\u6807\u51c6\u86cb\u767d\u5206\u89e3\u7387\uff08normalized protein catabolic rate\uff0cnPCR\uff09\u53ca\u8425\u517b\u76f8\u5173\u7684\u4f53\u683c\u68c0\u67e5\u6307\u6807\u7b49\u3002<\/p>\n

5. \u900f\u6790\u5145\u5206\u6027\u8bc4\u4f30\uff1a\u6bcf3~6\u4e2a\u6708\u8bc4\u4f301\u6b21\u900f\u6790\u5145\u5206\u6027\uff0c\u5305\u62ecKt\/V\u548c\u5c3f\u7d20\u4e0b\u964d\u7387\uff08urea reduction rate\uff0cURR\uff09\u3002<\/p>\n

6. \u4f20\u67d3\u75c5\u5b66\u6307\u6807\uff1a\u5305\u62ec\u4e59\u578b\u548c\u4e19\u578b\u809d\u708e\u75c5\u6bd2\u6807\u5fd7\u7269\u3001\u827e\u6ecb\u75c5\u75c5\u6bd2\u548c\u6885\u6bd2\u8840\u6e05\u5b66\u6307\u6807\u3002\u5efa\u8bae\u5f00\u59cb\u900f\u6790\u4e0d\u6ee16\u4e2a\u6708\u60a3\u8005\uff0c\u6bcf1~3\u4e2a\u6708\u68c0\u6d4b1\u6b21\uff1b\u7ef4\u6301\u6027\u900f\u67906\u4e2a\u6708\u4ee5\u4e0a\u60a3\u8005\uff0c\u6bcf6\u4e2a\u6708\u68c0\u6d4b1\u6b21\u3002<\/p>\n

7. \u5fc3\u8840\u7ba1\u7ed3\u6784\u548c\u529f\u80fd\u68c0\u67e5\uff1a\u6bcf6~12\u4e2a\u6708\u8fdb\u884c1\u6b21\u5fc3\u8840\u7ba1\u7ed3\u6784\u548c\u529f\u80fd\u68c0\u67e5\uff0c\u5305\u62ec\u5fc3\u7535\u56fe\u3001\u5fc3\u810f\u8d85\u58f0\u3001\u5916\u5468\u8840\u7ba1\u591a\u666e\u52d2\u8d85\u58f0\u7b49\u3002<\/p>\n

8. \u8840\u7ba1\u9499\u5316\u8bc4\u4f30\uff1a\u6bcf12\u4e2a\u6708\u8fdb\u884c1\u6b21\u8170\u690e\u4fa7\u4f4dX\u7ebf\u68c0\u67e5\uff0c\u8bc4\u4f30\u8840\u7ba1\u9499\u5316\u3002<\/p>\n

9. \u4e2d\u5206\u5b50\u6bd2\u7d20\u548c\u708e\u75c7\u6307\u6807\uff1a\u6709\u6761\u4ef6\u7684\u5355\u4f4d\u5efa\u8bae\u5bf9\u60a3\u8005\u4e2d\u5206\u5b50\u6bd2\u7d20\u548c\u708e\u75c7\u6307\u6807\u7b49\uff08\u5982IL-6\u3001IL-18\u3001\u03b22-\u5fae\u7403\u86cb\u767d\u3001\u03b11-\u5fae\u7403\u86cb\u767d\u3001\u6210\u7ea4\u7ef4\u7ec6\u80de\u751f\u957f\u56e0\u5b5023\u7b49\uff09\u8fdb\u884c\u68c0\u6d4b\u8bc4\u4f30\uff0c\u6bcf3~6\u4e2a\u67081\u6b21\uff0c\u4ee5\u4fbf\u66f4\u597d\u5730\u8bc4\u4ef7HDF\u7684\u7597\u6548\u3002<\/p>\n

\u56db\u3001HDF\u9002\u5e94\u8bc1\u4e0e\u8bc4\u4f30\u7684\u533b\u7597\u8d28\u91cf\u63a7\u5236\u6307\u6807<\/p>\n

\u63a8\u8350\u610f\u89c17\uff1a\u5efa\u8baeHDF\u9002\u5e94\u8bc1\u4e0e\u8bc4\u4f30\u6309\u4ee5\u4e0b\u6307\u6807\u8fdb\u884c\u533b\u7597\u8d28\u91cf\u63a7\u5236\u3002\uff08D5\uff09<\/p>\n

\uff08\u4e00\uff09HDF\u6cbb\u7597\u7387<\/p>\n

\u5355\u4f4d\u65f6\u95f4\u5185\uff0c\u63a5\u53d7HDF\u6cbb\u7597\u7684\u60a3\u8005\u5360\u540c\u671f\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u6bd4\u4f8b\u3002<\/p>\n

\uff08\u4e8c\uff09\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u5b9a\u671f\u8bc4\u4f30\u5b8c\u6210\u7387<\/p>\n

1. \u8840\u5e38\u89c4\u5b9a\u671f\u68c0\u9a8c\u5b8c\u6210\u7387\uff1a\u6bcf3\u4e2a\u6708\u5b8c\u6210\u8840\u5e38\u89c4\u68c0\u9a8c\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

2. \u8840\u6db2\u751f\u5316\u5b9a\u671f\u68c0\u9a8c\u5b8c\u6210\u7387\uff1a\u6bcf3\u4e2a\u6708\u5b8c\u6210\u8840\u6db2\u751f\u5316\uff08\u5305\u62ec\u809d\u80be\u529f\u80fd\u3001\u7535\u89e3\u8d28\u3001\u8840\u8102\u7b49\uff09\u68c0\u9a8c\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

3. \u7532\u72b6\u65c1\u817a\u6fc0\u7d20\u5b9a\u671f\u68c0\u9a8c\u5b8c\u6210\u7387\uff1a\u6bcf6\u4e2a\u6708\u5b8c\u6210\u5168\u6bb5\u7532\u72b6\u65c1\u817a\u6fc0\u7d20\uff08iPTH\uff09\u68c0\u9a8c\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

4. \u8840\u6e05\u94c1\u86cb\u767d\u548c\u8f6c\u94c1\u86cb\u767d\u9971\u548c\u5ea6\u5b9a\u671f\u68c0\u9a8c\u5b8c\u6210\u7387\uff1a\u6bcf6\u4e2a\u6708\u5b8c\u6210\u8840\u6e05\u94c1\u86cb\u767d\u548c\u8f6c\u94c1\u86cb\u767d\u9971\u548c\u5ea6\u68c0\u9a8c\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

5. \u8840\u6e05\u524d\u767d\u86cb\u767d\u5b9a\u671f\u68c0\u9a8c\u5b8c\u6210\u7387\uff1a\u6bcf6\u4e2a\u6708\u5b8c\u6210\u524d\u767d\u86cb\u767d\u68c0\u9a8c\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

6. C\u53cd\u5e94\u86cb\u767d\u5b9a\u671f\u68c0\u9a8c\u5b8c\u6210\u7387\uff1a\u6bcf6\u4e2a\u6708\u5b8c\u6210C\u53cd\u5e94\u86cb\u767d\u68c0\u9a8c\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

7. Kt\/V\u548cURR\u5b9a\u671f\u8bb0\u5f55\u5b8c\u6210\u7387\uff1a\u6bcf6\u4e2a\u6708\u5b8c\u6210Kt\/V\u548cURR\u8bb0\u5f55\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u6bd4\u4f8b\u3002<\/p>\n

8. \u03b22-\u5fae\u7403\u86cb\u767d\u5b9a\u671f\u68c0\u9a8c\u5b8c\u6210\u7387\uff1a\u6bcf6\u4e2a\u6708\u5b8c\u6210\u03b22-\u5fae\u7403\u86cb\u767d\u68c0\u9a8c\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u6bd4\u4f8b\u3002<\/p>\n

9. \u8840\u6e90\u6027\u4f20\u67d3\u75c5\u6807\u5fd7\u7269\u5b9a\u671f\u68c0\u9a8c\u5b8c\u6210\u7387\uff1a\u6bcf6\u4e2a\u6708\u5b8c\u6210\u4e59\u578b\u809d\u708e\u3001\u4e19\u578b\u809d\u708e\u3001\u6885\u6bd2\u53ca\u827e\u6ecb\u75c5\u6807\u5fd7\u7269\u68c0\u9a8c\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u6bd4\u4f8b\u3002<\/p>\n

\u7b2c\u4e09\u90e8\u5206 HDF\u7684\u6cbb\u7597\u6a21\u5f0f\u4e0e\u9009\u62e9<\/p>\n

\u4e00\u3001on-line HDF\u6cbb\u7597\u6a21\u5f0f\u79cd\u7c7b\u53ca\u7279\u70b9<\/p>\n

on-line HDF\u6cbb\u7597\u6a21\u5f0f\u6839\u636e\u7f6e\u6362\u6db2\u63a5\u5165\u4f4d\u7f6e\u5206\u4e3a\u524d\u7a00\u91caHDF\u3001\u540e\u7a00\u91caHDF\u548c\u6df7\u5408\u7a00\u91caHDF\u3002\u7531\u4e8e\u80fd\u591f\u8fdb\u884c\u6df7\u5408\u7a00\u91caHDF\u6cbb\u7597\u7684\u900f\u6790\u673a\u76ee\u524d\u6211\u56fd\u4f7f\u7528\u7387\u5f88\u4f4e\uff0c\u4e14\u6df7\u5408\u7a00\u91caHDF\u6cbb\u7597\u7684\u6709\u6548\u5242\u91cf\u7684\u4e34\u5e8a\u7814\u7a76\u8bc1\u636e\u4e0d\u8db3\uff1b\u56e0\u6b64\u672c\u6307\u5357\u4e3b\u8981\u4ecb\u7ecd\u524d\u7a00\u91caHDF\u548c\u540e\u7a00\u91caHDF\u3002<\/p>\n

1. \u524d\u7a00\u91caHDF\uff1a\u7f6e\u6362\u6db2\u7531\u900f\u6790\u5668\u4e0a\u6e38\uff08\u52a8\u8109\u7aef\uff09\u63a5\u5165\u3002\u4e0e\u540e\u7a00\u91caHDF\u76f8\u6bd4\uff0c\u524d\u7a00\u91caHDF\u53ef\u5b9e\u73b0\u66f4\u9ad8\u7684\u8d85\u6ee4\u7387\uff08\u53ef\u9ad8\u8fbe\u8840\u6d41\u901f\u5ea6\u7684100%\uff09\uff0c\u907f\u514d\u540e\u7a00\u91caHDF\u76f8\u5173\u7684\u8840\u6db2\u6d53\u7f29\uff0c\u5177\u6709\u8840\u6d41\u963b\u529b\u5c0f\uff0c\u6b8b\u4f59\u8840\u91cf\u5c11\uff0c\u4e0d\u6613\u5f62\u6210\u6ee4\u8fc7\u819c\u4e0a\u7684\u86cb\u767d\u8986\u76d6\u5c42\uff0c\u4e0d\u6613\u53d1\u751f\u4f53\u5916\u5faa\u73af\u51dd\u8840\u7b49\u4f18\u70b9\u3002\u7136\u800c\uff0c\u524d\u7a00\u91caHDF\u6cbb\u7597\u65f6\u8840\u5ba4\u5185\u6eb6\u8d28\u6d53\u5ea6\u7684\u964d\u4f4e\u5bfc\u81f4\u901a\u8fc7\u6269\u6563\u548c\u5bf9\u6d41\u6e05\u9664\u6eb6\u8d28\u7684\u6548\u7387\u4e0b\u964d\u3002\u56e0\u6b64\u4e3a\u4e86\u8fbe\u5230\u76f8\u540c\u7684\u6e05\u9664\u6548\u7387\uff0c\u524d\u7a00\u91caHDF\u7684\u7f6e\u6362\u6db2\u5242\u91cf\u81f3\u5c11\u8981\u8fbe\u5230\u540e\u7a00\u91caHDF\u76842\u500d\u4ee5\u4e0a\u3002<\/p>\n

2. \u540e\u7a00\u91caHDF\uff1a\u7f6e\u6362\u6db2\u7531\u900f\u6790\u5668\u4e0b\u6e38\u63a5\u5165\uff0c\u901a\u5e38\u6ce8\u5165\u9759\u8109\u58f6\u4e2d\u3002HDF\u6cbb\u7597\u4e2d\u7684\u8d85\u6ee4\u7387\u5f88\u9ad8\uff0c\u6545\u80fd\u6709\u6548\u9632\u6b62\u9ad8\u901a\u91cfHD\u6cbb\u7597\u4e2d\u5bb9\u6613\u53d1\u751f\u7684\u53cd\u5411\u8d85\u6ee4\u73b0\u8c61\u3002\u540e\u7a00\u91caHDF\u662f\u6700\u6709\u6548\u7684\u6eb6\u8d28\u6e05\u9664\u65b9\u6cd5\uff0c\u4f46\u5176\u6f5c\u5728\u7684\u7f3a\u70b9\u662f\u8f83\u9ad8\u7684\u8d85\u6ee4\u7387\u4f1a\u5f15\u8d77\u8840\u6db2\u6d53\u7f29\uff0c\u4ece\u800c\u5bfc\u81f4\u8840\u6d46\u86cb\u767d\u6c89\u79ef\u4e8e\u534a\u900f\u819c\u7684\u8868\u9762\uff0c\u5835\u585e\u900f\u6790\u5668\u7684\u819c\u5b54\u548c\u8840\u6db2\u901a\u9053\u3002\u8fd9\u4e9b\u6548\u5e94\u4f1a\u5347\u9ad8\u8de8\u819c\u538b\uff08transmembrane pressure\uff0cTMP\uff09\u5f15\u53d1\u62a5\u8b66\uff0c\u964d\u4f4e\u6eb6\u8d28\u6e05\u9664\u80fd\u529b\u5e76\u53ef\u80fd\u5bfc\u81f4\u4f53\u5916\u5faa\u73af\u51dd\u8840\u7684\u53d1\u751f\u3002<\/p>\n

\u524d\u7a00\u91ca\u548c\u540e\u7a00\u91caHDF\u6cbb\u7597\u6a21\u5f0f\u7684\u4f18\u7f3a\u70b9\u548c\u9002\u7528\u4eba\u7fa4\u89c1\u88682\u3002<\/p>\n

\u4e8c\u3001\u4e0d\u540cHDF\u6cbb\u7597\u6a21\u5f0f\u7684\u9009\u62e9<\/p>\n

\u63a8\u8350\u610f\u89c18\uff1a\u9700\u7ed3\u5408\u60a3\u8005\u75c5\u60c5\u3001\u6280\u672f\u8bbe\u5907\u7684\u53ef\u53ca\u6027\u53ca\u533b\u7597\u4fdd\u9669\u653f\u7b56\u7b49\u591a\u79cd\u56e0\u7d20\u8fdb\u884c\u7efc\u5408\u8003\u8651\u9009\u62e9HDF\u6a21\u5f0f\u3002\uff08D5\uff09<\/p>\n

\u76ee\u524d\u6b27\u6d32\u56fd\u5bb690%\u7684\u60a3\u8005\u91c7\u7528\u540e\u7a00\u91ca\u6cbb\u7597\u6a21\u5f0f\uff0c\u5bf9\u6d41\u91cf>21 L\/\u6b21\uff0c\u6bcf\u54683\u6b21\uff0c\u6bcf\u6b214 h\uff0c\u5e73\u5747\u8840\u6d41\u91cf350 ml\/min\uff1b\u65e5\u672c90%\u7684\u60a3\u8005\u91c7\u7528\u524d\u7a00\u91ca\u6a21\u5f0f\uff0c\u5e73\u5747\u5bf9\u6d41\u91cf40 L\/\u6b21\uff0c\u6bcf\u54683\u6b21\uff0c\u6bcf\u6b215 h\uff0c\u5e73\u5747\u8840\u6d41\u91cf180 ml\/min\uff3b34\uff3d<\/sup>\u3002<\/p>\n

\u5efa\u8bae\u57fa\u4e8e\u4e0a\u8ff02\u79cd\u6cbb\u7597\u6a21\u5f0f\u7684\u4f18\u7f3a\u70b9\u548c\u9002\u7528\u4eba\u7fa4\uff0c\u4ee5\u53ca\u533b\u7597\u673a\u6784\u7684\u6280\u672f\u8bbe\u5907\u7684\u53ef\u53ca\u6027\u53ca\u533b\u7597\u4fdd\u9669\u653f\u7b56\u7b49\u591a\u79cd\u56e0\u7d20\u8fdb\u884c\u7efc\u5408\u8003\u8651\u9009\u62e9HDF\u6a21\u5f0f\u3002<\/p>\n

\u63a8\u8350\u610f\u89c19\uff1a\u63a8\u8350\u8840\u6d41\u901f250~300 ml\/min\u6216>300 ml\/min\u7684\u60a3\u8005\uff0c\u7ed3\u5408\u7ea2\u7ec6\u80de\u6bd4\u5bb9\u6c34\u5e73\uff0c\u9009\u62e9\u540e\u7a00\u91caHDF\u6cbb\u7597\u6a21\u5f0f\uff08A1a\uff09\uff1b\u4e5f\u53ef\u6839\u636e\u75c5\u60c5\u9700\u6c42\u9009\u62e9\u5e94\u7528\uff08D5\uff09\u3002<\/p>\n

\u540e\u7a00\u91caHDF\u7684\u7f6e\u6362\u6db2\u7528\u91cf\u8f83\u524d\u7a00\u91ca\u7f6e\u6362\u6cd5\u5c11\uff0c\u800c\u6e05\u9664\u6548\u7387\u8f83\u524d\u7a00\u91ca\u7f6e\u6362\u6cd5\u9ad8\uff0c\u4f46\u5bb9\u6613\u5bfc\u81f4\u9ad8\u51dd\u72b6\u6001\u7684\u60a3\u8005\u6ee4\u5668\u51dd\u8840\uff3b35\uff3d<\/sup>\u3002\u591a\u4e2d\u5fc3\u3001\u524d\u77bb\u6027\u3001\u968f\u673a\u5bf9\u7167\u7684ESHOL\u7814\u7a76\u8bc1\u5b9e\u9ad8\u5bb9\u91cf\u540e\u7a00\u91caHDF\u663e\u8457\u964d\u4f4e\u60a3\u8005\u7684\u5168\u56e0\u6b7b\u4ea1\u548c\u5fc3\u8840\u7ba1\u75c5\u6b7b\u4ea1\u98ce\u9669\uff3b5\uff3d<\/sup>\u3002\u57fa\u4e8e4\u9879\u968f\u673a\u5bf9\u7167\u7814\u7a76\u7684\u60a3\u8005\u4e2a\u4f53\u6570\u636e\u6c47\u603b\u5206\u6790\u4e5f\u8bc1\u5b9e\uff0c\u9ad8\u5bb9\u91cf\u540e\u7a00\u91caon-line HDF\u6cbb\u7597\u80fd\u964d\u4f4e\u5168\u56e0\u6b7b\u4ea1\u548c\u5fc3\u8840\u7ba1\u75c5\u6b7b\u4ea1\u98ce\u9669\uff3b15\uff3d<\/sup>\u3002Basile\u7b49\uff3b36\uff3d<\/sup>\u7cfb\u7edf\u7efc\u8ff0\u4e86\u9ad8\u5bb9\u91cf\u540e\u7a00\u91caHDF\u76f8\u5173\u7814\u7a76\uff0c\u8ba4\u4e3a\u5927\u591a\u6570\u53ef\u7528\u6570\u636e\u652f\u6301\u9009\u62e9\u9ad8\u5bb9\u91cf\u540e\u7a00\u91caHDF\u3002<\/p>\n

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\u63a8\u8350\u610f\u89c110\uff1a\u5efa\u8bae\u8840\u6d41\u901f\u2264250 ml\/min\u6216\u7ea2\u7ec6\u80de\u6bd4\u5bb9>35%\u7684\u60a3\u8005\u9009\u62e9\u524d\u7a00\u91caHDF\u6cbb\u7597\u6a21\u5f0f\u3002\uff08B2b\uff09<\/p>\n

\u65e5\u672cHDF\u4e2d90%\u4ee5\u4e0a\u91c7\u7528\u524d\u7a00\u91ca\u6cbb\u7597\u6a21\u5f0f\u3002\u57fa\u4e8e\u65e5\u672c\u900f\u6790\u6cbb\u7597\u5b66\u4f1a\u80be\u810f\u6570\u636e\u6ce8\u518c\u6570\u636e\u5e93\u521b\u5efa\u76845 000\u5bf9\u60a3\u8005\u7684\u8840\u6db2\u900f\u6790\u6216\u524d\u7a00\u91caon-line HDF\u503e\u5411\u5339\u914d\u961f\u5217\u7814\u7a76\u8bc1\u5b9e\uff0c\u7f6e\u6362\u91cf>40 L\/\u6b21\u7684\u524d\u7a00\u91caHDF\u60a3\u8005\u76841\u5e74\u5168\u56e0\u6b7b\u4ea1\u7387\u548c\u5fc3\u8840\u7ba1\u75c5\u6b7b\u4ea1\u7387\u5747\u663e\u8457\u4f4e\u4e8e\u8840\u6db2\u900f\u6790\u60a3\u8005\uff3b39\uff3d<\/sup>\u300290\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u524d\u77bb\u6027\u968f\u673a\u5e73\u884c\u4ea4\u53c9\u7814\u7a76\u4e2d\u671f\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u524d\u7a00\u91ca\u548c\u540e\u7a00\u91ca\u6cbb\u7597\u6a21\u5f0f\u60a3\u8005\u7684\u8840\u538b\u3001\u900f\u6790\u4e2d\u4f4e\u8840\u538b\u9891\u7387\u6216\u4efb\u4f55\u4f4e\u8840\u538b\u6d4b\u91cf\u9891\u7387\u65e0\u663e\u8457\u5dee\u5f02\uff0c\u03b22-\u5fae\u7403\u86cb\u767d\u6e05\u9664\u7387\u548c\u60a3\u8005\u751f\u6d3b\u8d28\u91cf\u4e5f\u65e0\u663e\u8457\u5dee\u5f02\uff0c\u4f46\u5355\u6b21\u900f\u6790\u8fc7\u7a0b\u4e2d\u540e\u7a00\u91ca\u6cbb\u7597\u6a21\u5f0f\u7684\u767d\u86cb\u767d\u4e22\u5931\u663e\u8457\u5927\u4e8e\u524d\u7a00\u91ca\u6cbb\u7597\u6a21\u5f0f\uff084.87 g\u6bd43.78 g\uff09\uff3b40\uff3d<\/sup>\u3002\u65e5\u672c\u91c7\u7528\u524d\u7a00\u91caHDF\u6cbb\u7597\u6a21\u5f0f\u7684\u4e3b\u8981\u539f\u56e0\u5305\u62ec\uff1a\uff081\uff09\u6709\u6548\u6e05\u9664\u5206\u5b50\u91cf\u5927\u4e8e\u03b22-\u5fae\u7403\u86cb\u767d\u7684\u4e2d\u5927\u5206\u5b50\u91cf\u86cb\u767d\uff08\u5305\u62ec\u708e\u6027\u7ec6\u80de\u56e0\u5b50\u3001\u5176\u4ed6\u751f\u7269\u6d3b\u6027\u86cb\u767d\u548c\u86cb\u767d\u7ed3\u5408\u7684\u5c3f\u6bd2\u75c7\u6bd2\u7d20\uff09\uff1a\u5c3d\u7ba1\u540e\u7a00\u91caHDF\u8f83\u524d\u7a00\u91caHDF\u66f4\u6709\u6548\u5730\u6e05\u9664\u5206\u5b50\u91cf\u2264\u03b22-\u5fae\u7403\u86cb\u767d\u7684\u4f4e\u5206\u5b50\u91cf\u86cb\u767d\uff0c\u5f53\u91c7\u7528\u5927\u5b54\u6ee4\u8fc7\u5668\u6e05\u9664\u4f4e\u5206\u5b50\u91cf\u86cb\u767d\u65f6\uff0c\u540e\u7a00\u91caHDF\u6cbb\u7597\u6a21\u5f0f\u5b58\u5728\u663e\u8457\u7684\u767d\u86cb\u767d\u4e22\u5931\u98ce\u9669\uff1b\u4f46\u662f\uff0c\u53ef\u4ee5\u901a\u8fc7\u9009\u62e9\u5408\u9002\u7684\u5b54\u5f84\u548c\u63a7\u5236\u5bf9\u6d41\u901f\u5ea6\u8c03\u8282\u4f4e\u5206\u5b50\u91cf\u86cb\u767d\u6e05\u9664\uff0c\u4f46\u901a\u5e38\u9700\u8981\u66f4\u591a\u7684\u7f6e\u6362\u6db2\u5242\u91cf\uff0c\u56e0\u6b64\u9700\u8981\u66f4\u9ad8\u7684\u8840\u6d41\u91cf\u3002\uff082\uff09\u65e5\u672c\u900f\u6790\u60a3\u8005\u7684\u8840\u6d41\u901f\u8f83\u4f4e\uff0c\u5e73\u5747\u4e3a200 ml\/min\uff1b\u4f46\u524d\u7a00\u91caon-line HDF\u53ef\u65e0\u9650\u5236\u5730\u589e\u52a0\u7f6e\u6362\u6db2\u5242\u91cf\uff3b40\uff3d<\/sup>\u3002<\/p>\n

\u56e0\u6b64\uff0c\u524d\u7a00\u91caHDF\u9002\u7528\u4e8e\u8840\u7ba1\u901a\u8def\u4e0d\u4f73\u5bfc\u81f4\u8840\u6d41\u91cf\u8f83\u4f4e\uff0c\u4f34\u6709\u9ad8\u51dd\u72b6\u6001\u6216\u7ea2\u7ec6\u80de\u6bd4\u5bb9\u8f83\u9ad8\u96be\u4ee5\u63a5\u53d7\u540e\u7a00\u91caHDF\u6cbb\u7597\u7684\u60a3\u8005\u3002<\/p>\n

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1. \u540e\u7a00\u91caHDF\u6cbb\u7597\u9002\u5e94\u8bc1\u7b26\u5408\u7387\uff1a\u8840\u6d41\u91cf250~300 ml\/min\u6216>300 ml\/min\u7ed3\u5408\u7ea2\u7ec6\u80de\u6bd4\u5bb9\u6c34\u5e73\u91c7\u7528\u540e\u7a00\u91caHDF\u6cbb\u7597\u6a21\u5f0f\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

2. \u524d\u7a00\u91caHDF\u6cbb\u7597\u9002\u5e94\u8bc1\u7b26\u5408\u7387\uff1a\u8840\u6d41\u91cf\u2264250 ml\/min\u6216\u7ea2\u7ec6\u80de\u6bd4\u5bb9>35%\u60a3\u8005\u91c7\u7528\u524d\u7a00\u91caHDF\u6cbb\u7597\u6a21\u5f0f\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

\u7b2c\u56db\u90e8\u5206 \u7f6e\u6362\u6db2\u7684\u9009\u62e9\u4e0e\u6210\u5206\u8c03\u6574<\/p>\n

HDF\u6cbb\u7597\u7528\u7f6e\u6362\u6db2\u5305\u62ec\uff1a\u8054\u673a\u6cd5\uff08on-line\uff09\u83b7\u5f97\u7684\u7f6e\u6362\u6db2\u548c\u5546\u54c1\u5316\u7f6e\u6362\u6db2\u3002On-line\u83b7\u5f97\u7684\u7f6e\u6362\u6db2\u7528\u4e8eon-line HDF\u6cbb\u7597\uff1b\u5546\u54c1\u5316\u7f6e\u6362\u6db2\u7528\u4e8e\u975e\u8054\u673aHDF\u6cbb\u7597\uff0c\u9002\u7528\u4e8e\u9700\u8981\u8c03\u6574\u7f6e\u6362\u6db2\u4e2d\u7535\u89e3\u8d28\u6d53\u5ea6\u6cbb\u7597\u7684\u5408\u5e76\u4e25\u91cd\u7535\u89e3\u8d28\u7d0a\u4e71\u3001\u4e25\u91cd\u8840\u7cd6\u5f02\u5e38\u4ee5\u53ca\u5408\u5e76\u51fa\u8840\u6216\u9ad8\u5371\u51fa\u8840\u98ce\u9669\u91c7\u7528\u5c40\u90e8\u67b8\u6a7c\u9178\u94a0\u6297\u51dd\u6cbb\u7597\u7684\u60a3\u8005\u3002<\/p>\n

\u4e00\u3001HDF\u7f6e\u6362\u6db2\u7684\u9009\u62e9<\/p>\n

\u63a8\u8350\u610f\u89c112\uff1a\u63a8\u8350on-line HDF\u7f6e\u6362\u6db2\u7528\u4e8e\u7ec8\u672b\u671f\u80be\u75c5\u60a3\u8005\u7ef4\u6301\u6027\u6cbb\u7597\u3002\uff08A1b\uff09<\/p>\n

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\u4e8c\u3001\u7f6e\u6362\u6db2\u6210\u5206\u7684\u8c03\u6574<\/p>\n

\u63a8\u8350\u610f\u89c113\uff1a\u7f6e\u6362\u6db2\u7684\u57fa\u672c\u6210\u5206\u5e94\u4e0e\u4eba\u4f53\u5185\u751f\u7406\u6d53\u5ea6\u76f8\u7b26\u3002\uff08D5\uff09<\/p>\n

HDF\u7f6e\u6362\u6db2\u4f5c\u4e3a\u76f4\u63a5\u8f93\u5165\u8840\u6db2\u7684\u6210\u5206\uff0c\u5176\u6eb6\u8d28\u6210\u5206\u4e3b\u8981\u5305\u62ec\u94a0\u3001\u94be\u3001\u6c2f\u3001\u78b1\u57fa\u3001\u9499\u3001\u9541\u3001\u78f7\u53ca\u8461\u8404\u7cd6\u7b49\uff0c\u914d\u65b9\u539f\u5219\u4e0a\u8981\u4e0e\u751f\u7406\u6d53\u5ea6\u76f8\u7b26\uff0c\u5e76\u80fd\u6539\u5584\u7ec8\u672b\u671f\u80be\u75c5\u60a3\u8005\u7684\u5185\u73af\u5883\u3002\u5e38\u7528\u7f6e\u6362\u6db2\u914d\u65b9\uff1a\u94a0135~145 mmol\/L\u3001\u94be2.0~3.0 mmol\/L\u3001\u94991.25~1.75 mmol\/L\u3001\u95410.50~0.75 mmol\/L\u3001\u6c2f103~110 mmol\/L\u3001\u78b3\u9178\u6c22\u76d030~34 mmol\/L\u3002<\/p>\n

\u63a8\u8350\u610f\u89c114\uff1a\u6839\u636e\u60a3\u8005\u75c5\u60c5\u5bf9\u7f6e\u6362\u6db2\u6210\u5206\u8fdb\u884c\u9002\u5f53\u8c03\u6574\uff0c\u8fbe\u5230\u4e2a\u4f53\u5316\u6cbb\u7597\u3002\uff08D5\uff09<\/p>\n

on-line HDF\u7f6e\u6362\u6db2\u6210\u5206\u76f8\u5bf9\u56fa\u5b9a\uff0c\u800c\u5546\u54c1\u5316\u7f6e\u6362\u6db2\u53ef\u6839\u636e\u60a3\u8005\u7535\u89e3\u8d28\u6c34\u5e73\u5bf9\u94be\u3001\u94a0\u3001\u9499\u7b49\u7535\u89e3\u8d28\u6d53\u5ea6\u505a\u51fa\u8c03\u6574\u3002\u5982\u5bf9\u4e25\u91cd\u9ad8\u94a0\u8840\u75c7\u60a3\u8005\uff0c\u4e00\u822c\u8c03\u6574\u7f6e\u6362\u6db2\u94a0\u6d53\u5ea6\u81f3\u4f4e\u4e8e\u60a3\u8005\u8840\u94a0\u6d53\u5ea610 mmol\/L\uff0c\u4ee5\u9632\u8840\u94a0\u6d53\u5ea6\u4e0b\u964d\u8fc7\u5feb\u9020\u6210\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u7b49\u635f\u5bb3\u3002\u5bf9\u4f4e\u94be\u8840\u75c7\u7684\u60a3\u8005\uff0c\u53ef\u5728\u7f6e\u6362\u6db2\u4e2d\u52a0\u5165\u9002\u91cf\u6c2f\u5316\u94be\u3002\u9ad8\u9499\u60a3\u8005\u53ef\u9009\u7528\u751f\u7406\u9499\u7f6e\u6362\u6db2\uff081.25 mmol\/L\uff09\u3002\u5e38\u89c4\u7f6e\u6362\u6db2\u4e2d\u4e0d\u542b\u78f7\uff0c\u4f46\u5bf9\u4f4e\u78f7\u8840\u75c7\u6216\u9700\u8981\u957f\u65f6\u95f4\u6cbb\u7597\u7684\u60a3\u8005\u63a8\u8350\u914d\u5236\u7f6e\u6362\u6db2\u7684\u78f7\u6d53\u5ea6\u4e3a0.7~1.0 mmol\/L\u3002\u8840\u7cd6\u4ee3\u8c22\u5f02\u5e38\u60a3\u8005\u63a8\u8350\u8c03\u6574\u5546\u54c1\u5316\u7f6e\u6362\u6db2\u8461\u8404\u7cd6\u7684\u6d53\u5ea6\u4e8e5~12 mmol\/L\u3002\u6b64\u5916\uff0c\u5bf9\u809d\u529f\u80fd\u4e25\u91cd\u5f02\u5e38\u7684\u60a3\u8005\u5efa\u8bae\u4f7f\u7528Port\u914d\u65b9\u6216\u6539\u826fPort\u914d\u65b9\u6cbb\u7597\uff0c\u9ad8\u51fa\u8840\u98ce\u9669\u60a3\u8005\u53ef\u9002\u7528\u67b8\u6a7c\u9178\u7f6e\u6362\u6db2\u5e76\u5728\u6ee4\u5668\u540e\u8865\u5145\u9499\uff3b42\uff3d<\/sup>\u3002<\/p>\n

\u4e09\u3001\u7f6e\u6362\u6db2\u548c\u900f\u6790\u6db2\u7684\u8d28\u91cf\u63a7\u5236<\/p>\n

\u63a8\u8350\u610f\u89c115\uff1a\u7f6e\u6362\u6db2\u5e94\u4e25\u683c\u7b26\u5408\u56fd\u9645\u6807\u51c6\u3002\uff08D5\uff09<\/p>\n

HDF\u6cbb\u7597\u4e2d\u7f6e\u6362\u6db2\u76f4\u63a5\u8fdb\u5165\u8840\u6db2\uff0c\u56e0\u6b64\u5bf9\u5176\u54c1\u8d28\u548c\u6210\u5206\u6709\u4e25\u683c\u7684\u8981\u6c42\u3002\u56fd\u9645\u6807\u51c6\u5316\u7ec4\u7ec7\uff08International Organization for Standardization\uff0cISO\uff09\u53d1\u5e03\u7684\u8840\u6db2\u900f\u6790\u53ca\u76f8\u5173\u6cbb\u7597\u7528\u6c34\u6807\u51c6\uff08ISO 11663\uff1a2014\uff09\u63d0\u51fa\u7528\u4e8eHDF\u6cbb\u7597\u7684\u7f6e\u6362\u6db2\u5fc5\u987b\u65e0\u83cc\u4e14\u65e0\u81f4\u70ed\u539f\uff3b43\uff3d<\/sup>\u3002\u5546\u54c1\u5316\u7f6e\u6362\u6db2\u4e00\u822c\u53c2\u8003\u9759\u8109\u8f93\u6db2\u6807\u51c6\uff1a\u5185\u6bd2\u7d20<0.03\u6d3b\u6027\u5355\u4f4d\uff08EU\uff09\/ml\u4e14\u7ec6\u83cc\u6570<1\u00d7106<\/sup>\u83cc\u843d\u5f62\u6210\u5355\u4f4d\uff08CFU\uff09\/ml\u3002\u6b64\u5916\uff0c\u7f6e\u6362\u6db2\u4e2d\u7684\u6eb6\u8d28\u6d53\u5ea6\u5e94\u4e0e\u4e0a\u8ff0\u751f\u7406\u6d53\u5ea6\u76f8\u7b26\u3002<\/p>\n

\u63a8\u8350\u610f\u89c116\uff1a\u900f\u6790\u7528\u6c34\u5e94\u8fbe\u5230\u56fd\u5bb6\u533b\u836f\u884c\u4e1a\u6807\u51c6YY 0572-2015\u300a\u8840\u6db2\u900f\u6790\u53ca\u76f8\u5173\u6cbb\u7597\u7528\u6c34\u300b\u8d28\u91cf\u6807\u51c6\uff0c\u6d53\u7f29\u900f\u6790\u6db2\u5e94\u8fbe\u5230\u56fd\u5bb6\u533b\u836f\u884c\u4e1a\u6807\u51c6YY 0598-2015\u300a\u8840\u6db2\u900f\u6790\u53ca\u76f8\u5173\u6cbb\u7597\u7528\u6d53\u7f29\u7269\u300b\u8d28\u91cf\u6807\u51c6\uff0c\u900f\u6790\u6db2\u5e94\u8fbe\u5230\u8d85\u7eaf\u900f\u6790\u6db2\u8d28\u91cf\u6807\u51c6\u3002\uff08D5\uff09<\/p>\n

\u56fd\u5bb6\u533b\u836f\u884c\u4e1a\u6807\u51c6YY 0572-2015\u300a\u8840\u6db2\u900f\u6790\u53ca\u76f8\u5173\u6cbb\u7597\u7528\u6c34\u300b\u89c4\u5b9a\uff1a\u900f\u6790\u7528\u6c34\u4e2d\u6bd2\u6027\u6c61\u67d3\u7269\u6700\u5927\u5141\u8bb8\u503c\uff1a\u603b\u6c2f\uff08\u6c2f\u548c\u6c2f\u80fa\uff090.1 mg\/L\u3001\u94dd0.01 mg\/L\u3001\u94dc0.1 mg\/L\u3001\u6c1f\u5316\u72690.2 mg\/L\u3001\u94c50.005 mg\/L\u3001\u785d\u9178\u76d0\uff08\u6c2e\uff092 mg\/L\u3001\u786b\u9178\u76d0100 mg\/L\u3001\u950c0.1 mg\/L\uff0c\u5fae\u91cf\u5143\u7d20\u6700\u5927\u5141\u8bb8\u503c\uff1a\u95110.006 mg\/L\u3001\u78370.006 mg\/L\u3001\u94a10.1 mg\/L\u3001\u94cd0.000 4 mg\/L\u3001\u95490.001 mg\/L\u3001\u94ec0.014 mg\/L\u3001\u6c5e0.000 2 mg\/L\u3001\u78520.09 mg\/L\u3001\u94f60.005 mg\/L\u548c\u94ca0.002 mg\/L\uff1b\u7ec6\u83cc\u548c\u5185\u6bd2\u7d20\u7684\u6700\u5927\u5141\u8bb8\u91cf\u5206\u522b\u4e3a100 CFU\/ml\u548c0.25 EU\/ml\uff0c\u5e76\u4e14\u660e\u786e\u63d0\u51fa\u5bf9\u7ec6\u83cc\u548c\u5185\u6bd2\u7d20\u542b\u91cf\u5fc5\u987b\u5efa\u7acb\u5e72\u9884\u6c34\u5e73\uff0c\u901a\u5e38\u5e72\u9884\u6c34\u5e73\u662f\u6700\u5927\u5141\u8bb8\u6c34\u5e73\u768450%\u3002<\/p>\n

\u56fd\u5bb6\u533b\u836f\u884c\u4e1a\u6807\u51c6YY 0598-2015\u300a\u8840\u6db2\u900f\u6790\u53ca\u76f8\u5173\u6cbb\u7597\u7528\u6d53\u7f29\u7269\u300b\u89c4\u5b9a\uff1a\u94a0\u79bb\u5b50\u6d53\u5ea6\u5e94\u4e3a\u6807\u793a\u91cf\u768497.5%~102.5%\u3002\u5176\u4ed6\u6eb6\u8d28\u6d53\u5ea6\u5e94\u4e3a\u6807\u793a\u91cf\u768495.0%~105.0%\uff1b\u7ec6\u83cc\u603b\u6570\u2264100 CFU\/ml\uff0c\u771f\u83cc\u603b\u6570\u226410 CFU\/ml\u3002\u5927\u80a0\u6746\u83cc\u5e94\u4e0d\u5f97\u68c0\u51fa\uff1b\u914d\u5236\u6210\u7684\u900f\u6790\u6db2\u5185\u6bd2\u7d20\u22640.5 EU\/ml\uff1b\u4e0d\u6eb6\u6027\u5fae\u7c92\uff1a\u226510 \u03bcm\u7684\u5fae\u7c92\u226425\u4e2a\/ml\uff0c\u226525 \u03bcm\u7684\u5fae\u7c92\u22643\u4e2a\/ml\u3002<\/p>\n

\u300a\u8840\u6db2\u51c0\u5316\u6807\u51c6\u64cd\u4f5c\u89c4\u7a0b\uff082021\u7248\uff09\u300b\u4e2d\u8d85\u7eaf\u900f\u6790\u6db2\u7684\u8d28\u91cf\u6807\u51c6\uff1a\u7ec6\u83cc\u6570<0.1 CFU\/ml\uff0c\u5185\u6bd2\u7d20<0.03 EU\/ml\u3002<\/p>\n

\u56db\u3001\u900f\u6790\u7528\u6c34\u548c\u900f\u6790\u6db2\u7684\u76d1\u6d4b\u9891\u7387\u4e0e\u8d28\u91cf\u8981\u6c42<\/p>\n

\uff08\u4e00\uff09\u900f\u6790\u7528\u6c34\u7684\u76d1\u6d4b\u9891\u7387\u4e0e\u8d28\u91cf\u8981\u6c42<\/p>\n

1. \u900f\u6790\u7528\u6c34\u786c\u5ea6\uff1a\u6bcf\u5929\u76d1\u6d4b1\u6b21\u900f\u6790\u7528\u6c34\u7684\u786c\u5ea6\uff0c\u63a8\u8350<1\u683c\u4ee4\uff08GPG\uff09\u621617.1 mg\/L\u3002<\/p>\n

2. \u603b\u6c2f\u91cf\uff1a\u6bcf\u5929\u76d1\u6d4b1\u6b21\u6d3b\u6027\u70ad\u7f50\u51fa\u6c34\u603b\u6c2f\uff0c\u8981\u6c42\u603b\u6c2f\u91cf<0.1 mg\/L\u3002<\/p>\n

3. \u751f\u7269\u6c61\u67d3\u76d1\u6d4b\uff1a\u7ec6\u83cc\u57f9\u517b\u5e94\u81f3\u5c11\u6bcf\u4e2a\u67081\u6b21\uff0c\u8981\u6c42\u7ec6\u83cc\u6570\u2264100 CFU\/ml\uff1b\u5185\u6bd2\u7d20\u68c0\u6d4b\u81f3\u5c11\u6bcf3\u4e2a\u67081\u6b21\uff0c\u8981\u6c42\u5185\u6bd2\u7d20\u22640.25 EU\/ml\u3002<\/p>\n

4. \u5316\u5b66\u6c61\u67d3\u7269\uff1a\u81f3\u5c11\u6bcf\u5e74\u68c0\u6d4b1\u6b21\uff0c\u9700\u8fbe\u5230\u4e0a\u8ff0\u56fd\u5bb6\u884c\u4e1a\u6807\u51c6\u300a\u8840\u6db2\u900f\u6790\u53ca\u76f8\u5173\u6cbb\u7597\u7528\u6c34\u300b\uff08YY0572-2015\uff09\u7684\u8981\u6c42\u3002<\/p>\n

\uff08\u4e8c\uff09\u900f\u6790\u6db2\u7684\u76d1\u6d4b\u9891\u7387\u4e0e\u8d28\u91cf\u8981\u6c42\uff3b41\uff3d<\/sup><\/p>\n

1. \u7ec6\u83cc\u76d1\u6d4b\uff1a\u6bcf\u4e2a\u67081\u6b21\uff0c\u6bcf\u6b21\u81f3\u5c11\u68c0\u6d4b2\u53f0\u8840\u6db2\u900f\u6790\u673a\uff0c\u6bcf\u53f0\u673a\u5668\u6bcf\u5e74\u81f3\u5c11\u68c0\u6d4b1\u6b21\uff1b\u8981\u6c42\u7ec6\u83cc\u6570<0.1 CFU\/ml\u3002<\/p>\n

2. \u5185\u6bd2\u7d20\u68c0\u6d4b\uff1a\u6bcf3\u4e2a\u67081\u6b21\uff0c\u6bcf\u6b21\u81f3\u5c11\u68c0\u6d4b2\u53f0\u8840\u6db2\u900f\u6790\u673a\uff0c\u6bcf\u53f0\u673a\u5668\u6bcf\u5e74\u81f3\u5c11\u68c0\u6d4b1\u6b21\uff1b\u8981\u6c42\u5185\u6bd2\u7d20<0.03 EU\/ml\u3002<\/p>\n

3. \u5185\u6bd2\u7d20\u8fc7\u6ee4\u5668\uff1a\u6309\u7167\u4ea7\u54c1\u4f7f\u7528\u8bf4\u660e\u4e2d\u9650\u5b9a\u7684\u6b21\u6570\u8981\u6c42\u8fdb\u884c\u66f4\u6362\u3002<\/p>\n

\uff08\u4e09\uff09HDF\u7f6e\u6362\u6db2\u548c\u900f\u6790\u6db2\u7684\u533b\u7597\u8d28\u91cf\u63a7\u5236\u6307\u6807<\/p>\n

\u63a8\u8350\u610f\u89c117\uff1a\u5efa\u8baeHDF\u7f6e\u6362\u6db2\u548c\u900f\u6790\u6db2\u6309\u7167\u4ee5\u4e0b\u6307\u6807\u8fdb\u884c\u533b\u7597\u8d28\u91cf\u63a7\u5236\u3002\uff08D5\uff09<\/p>\n

1. on-line HDF\u6cbb\u7597\u7387\uff1aon-line HDF\u6cbb\u7597\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

2. \u900f\u6790\u7528\u6c34\u5fae\u751f\u7269\u6c61\u67d3\u68c0\u9a8c\u5408\u683c\u7387\uff1a\u8840\u6db2\u900f\u6790\u5ba4\uff08\u4e2d\u5fc3\uff09\u900f\u6790\u7528\u6c34\u5fae\u751f\u7269\u6c61\u67d3\u68c0\u9a8c\u5408\u683c\u7684\u6708\u4efd\/\u5b63\u5ea6\u5728\u5f53\u5e74\u6240\u5360\u7684\u6bd4\u4f8b\u3002<\/p>\n

3. \u8d85\u7eaf\u900f\u6790\u6db2\u68c0\u9a8c\u5408\u683c\u7387\uff1a\u5355\u4f4d\u65f6\u95f4\u5185\uff0c\u8840\u6db2\u900f\u6790\u5ba4\uff08\u4e2d\u5fc3\uff09\u7b26\u5408\u8d85\u7eaf\u900f\u6790\u6db2\u6807\u51c6\u7684HDF\u6cbb\u7597\u900f\u6790\u673a\u6570\u91cf\u5360\u5168\u90e8HDF\u6cbb\u7597\u900f\u6790\u673a\u6570\u91cf\u7684\u6bd4\u4f8b\u3002<\/p>\n

\u7b2c\u4e94\u90e8\u5206 \u8840\u7ba1\u901a\u8def<\/p>\n

HDF\u6cbb\u7597\u4f7f\u7528\u7684\u8840\u7ba1\u901a\u8def\u57fa\u672c\u4e0a\u4e0e\u8840\u6db2\u900f\u6790\u4e00\u81f4\uff0c\u4f46\u540e\u7a00\u91caHDF\u9700\u8981\u66f4\u9ad8\u7684\u8840\u6d41\u91cf\u3002\u56e0\u6b64\uff0c\u9009\u62e9\u52a8\u9759\u8109\u5185\u7618\uff08arteriovenous fistula\uff0cAVFs\uff09\u548c\u79fb\u690d\u7269\u5185\u7618\uff08arteriovenous grafts\uff0cAVGs\uff09\u4f5c\u4e3a\u8840\u7ba1\u901a\u8def\u65f6\uff0c\u5e94\u4f7f\u752816 G\u4ee5\u4e0a\u5185\u5f84\u66f4\u5927\u7684\u7a7f\u523a\u9488\uff1b\u9009\u62e9\u5e26\u96a7\u9053\u5e26\u6da4\u7eb6\u5957\u4e2d\u5fc3\u9759\u8109\u5bfc\u7ba1\uff08tunneled cuffed central venous catheters\uff0cTCCs\uff09\u4f5c\u4e3a\u8840\u7ba1\u901a\u8def\u65f6\uff0c\u5e94\u9009\u62e9\u53ef\u6ee1\u8db3\u8f83\u5927\u8840\u6d41\u91cf\uff08\u2265300 ml\/min\uff09\u7684TCCs\u3002<\/p>\n

\u4e00\u3001HDF\u8840\u7ba1\u901a\u8def\u7684\u9009\u62e9<\/p>\n

\u63a8\u8350\u610f\u89c118\uff1a\u9009\u62e9HDF\u6cbb\u7597\u7684\u8840\u7ba1\u901a\u8def\uff0c\u5e94\u8bc4\u4f30\u60a3\u8005\u8840\u7ba1\u6761\u4ef6\u3001\u5fc3\u810f\u529f\u80fd\u53ca\u5168\u8eab\u6574\u4f53\u72b6\u6001\u4e0e\u9884\u671f\u751f\u5b58\u65f6\u95f4\u7b49\u4e34\u5e8a\u60c5\u51b5\u8fdb\u884c\u7efc\u5408\u51b3\u7b56\uff08D5\uff09\uff1b\u540c\u7b49\u6761\u4ef6\u4e0b\u4f18\u5148\u9009\u62e9AVFs\uff0c\u5176\u6b21\u9009\u62e9AVGs\u3001TCCs\uff08A1a\uff09\u3002<\/p>\n

\uff08\u4e00\uff09\u8bc4\u4f30\u60a3\u8005\u8840\u7ba1\u6761\u4ef6\u548c\u5168\u8eab\u72b6\u6001\u7b49\uff0c\u9009\u62e9\u8840\u7ba1\u901a\u8def<\/p>\n

\u9488\u5bf92 088\u4f8bAVFs\u548c1 728\u4f8bAVGs\u5177\u6709\u4e0d\u540c\u7279\u5f81\u60a3\u8005\u7684\u4e34\u5e8a\u60c5\u51b5\uff0c11\u540d\u56fd\u9645\u8840\u7ba1\u901a\u8def\u4e13\u5bb6\u91c7\u7528\u5170\u5fb7\/\u52a0\u5dde\u5927\u5b66\u6d1b\u6749\u77f6\u5206\u6821\uff08RAND\/UCLA\uff09\u9002\u5b9c\u6027\u65b9\u6cd5\uff0c\u5bf9\u6bcf\u79cd\u60c5\u51b5\u7684\u9002\u5b9c\u6027\u8fdb\u884c\u4e86\u4e24\u8f6e\u8bc4\u7ea7\uff0c\u7ed3\u679c\u663e\u793a\uff0c\u5e74\u9f84\u8f83\u5c0f\uff08<60\u5c81\uff09\u3001\u6d41\u51fa\u9759\u8109\u76f4\u5f84>2 mm\u3001\u6b63\u5e38\u6216\u80a5\u80d6\u4f53\u8d28\u6307\u6570\u3001\u6d41\u5165\u52a8\u8109\u76f4\u5f84>2 mm\u548c\u60a3\u8005\u529f\u80fd\u72b6\u6001\u8f83\u9ad8\u4e0eAVFs\u7684\u9002\u5b9c\u6027\u76f8\u5173\uff1b\u5e74\u9f84\u8f83\u5927\uff08>75\u5c81\uff09\u3001\u900f\u6790\u4f9d\u8d56\u6027\u548c\u9759\u8109\u76f4\u5f84<2 mm\u4e0eAVGs\u7684\u9002\u5b9c\u6027\u76f8\u5173\uff1b\u6027\u522b\u3001\u7cd6\u5c3f\u75c5\u548c\u51a0\u72b6\u52a8\u8109\u75be\u75c5\u4e0eAVFs\u6216AVGs\u7684\u9002\u5b9c\u6027\u65e0\u5173\uff1b\u900f\u6790\u72b6\u6001\uff08\u900f\u6790\u524d\u6216\u900f\u6790\u4f9d\u8d56\uff09\u4e0eAVFs\u7684\u9002\u5b9c\u6027\u65e0\u5173\uff1b\u4f53\u8d28\u6307\u6570\uff08\u6b63\u5e38\u3001\u80a5\u80d6\u6216\u75c5\u6001\u80a5\u80d6\uff09\u548c\u529f\u80fd\u72b6\u6001\uff08\u72ec\u7acb\u3001\u4e0d\u72ec\u7acb\u5c45\u5bb6\u6216\u5c45\u4f4f\u517b\u8001\u8bbe\u65bd\uff09\u4e0eAVGs\u7684\u9002\u5b9c\u6027\u65e0\u5173\uff3b44\uff3d<\/sup>\u3002<\/p>\n

23\u9879\u5bf9\u7167\u8bd5\u9a8c930\u4f8b\u7cd6\u5c3f\u75c5\u548c3 137\u4f8b\u975e\u7cd6\u5c3f\u75c5\u7ec8\u672b\u671f\u80be\u75c5\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u5408\u5e76\u7cd6\u5c3f\u75c5\u60a3\u8005\u7684AVFs\u5931\u8d25\u98ce\u9669\u589e\u52a0\uff08OR=1.682\uff0c95%CI\uff1a1.429~1.981\uff0cI2<\/sup>=9.7%\uff09\uff3b45\uff3d<\/sup>\u300210\u9879\u961f\u5217\u7814\u7a761 171\u4f8b\u6210\u5e74\u548c670\u4f8b\u8001\u5e74\u7ec8\u672b\u671f\u80be\u75c5\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u8001\u5e74\u60a3\u8005\u6bd4\u8f83\uff0c\u6210\u4eba\u60a3\u800512\u4e2a\u6708\uff08OR=1.525\uff0c95%CI\uff1a1.189~1.957\uff09\u548c24\u4e2a\u6708\uff08OR=1.357\uff0c95%CI\uff1a1.062~1.751\uff09\u7684AVFs\u901a\u7545\u7387\u5747\u663e\u8457\u589e\u52a0\uff1b\u8001\u5e74\u60a3\u8005\u884c\u6861\u52a8\u8109-\u5934\u9759\u8109\u543b\u5408AVFs\u7684\u624b\u672f\u5931\u8d25\u7387\u663e\u8457\u589e\u52a0\uff08OR=1.790\uff0c95%CI\uff0c1.136~2.821\uff09\uff1b\u8001\u5e74\u60a3\u8005\u4e2dAVGs\u4e0e\u6861\u52a8\u8109-\u5934\u9759\u8109\u543b\u5408AVFs\u7684\u624b\u672f\u5931\u8d25\u7387\u65e0\u660e\u663e\u5dee\u522b\uff3b46\uff3d<\/sup>\u3002<\/p>\n

\uff08\u4e8c\uff09\u4f18\u5148\u9009\u62e9AVFs<\/p>\n

200\u9879\u5bf9\u7167\/\u975e\u5bf9\u7167\u8bd5\u9a8c875 269\u6761\u8840\u7ba1\u901a\u8def\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c2\u5e74\u521d\u7ea7\u901a\u7545\u7387\uff0cAVFs\u4e3a55%\uff0cAVGs\u4e3a40%\uff0cTCCs\u4e3a50%\uff1b2\u5e74\u95f4AVGs\u611f\u67d3\u7387\u663e\u8457\u9ad8\u4e8eAVFs\uff0813%\u6bd42%\uff09\uff0c59\u5468TCCs\u611f\u67d3\u7387\u4e3a16%\uff1b\u60a3\u8005\u75c5\u6b7b\u7387\uff0cTCCs\u4e3a26%\uff0cAVGs\u4e3a17%\uff0cAVFs\u4e3a15%\uff0c\u4e14AVGs\u9ad8\u4e8eAVFs\uff08HR=1.278\uff0c95%CI\uff1a1.139~1.435\uff09\uff3b47\uff3d<\/sup>\u300262\u9879\u961f\u5217\u7814\u7a76586 337\u4f8b\u7684\u968f\u673a\u6548\u5e94\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0eAVFs\u6bd4\u8f83\uff0cTCCs\u589e\u52a0\u60a3\u8005\u5168\u56e0\u6b7b\u4ea1\u7387\uff08RR=1.53\uff0c95%CI\uff1a1.41~1.67\uff0cI2<\/sup>=83.1%\uff09\u3001\u81f4\u547d\u611f\u67d3\uff08RR=2.12\uff0c95%CI\uff1a1.79~2.52\uff0cI2<\/sup>=0\uff09\u548c\u5fc3\u8840\u7ba1\u4e8b\u4ef6\uff08RR=1.38\uff0c95%CI\uff1a1.24~1.54\uff0cI2<\/sup>=85.2%\uff09\u7684\u98ce\u9669\uff1b\u4e0eAVGs\u6bd4\u8f83\uff0cTCCs\u589e\u52a0\u60a3\u8005\u81f4\u547d\u611f\u67d3\uff08RR=1.49\uff0c95%CI\uff1a1.15~1.93\uff0cI2<\/sup>=25.6%\uff09\u548c\u5fc3\u8840\u7ba1\u4e8b\u4ef6\uff08RR=1.26\uff0c95%CI\uff1a1.11~1.43\uff0cI2<\/sup>=0\uff09\u7684\u98ce\u9669\uff1b\u4e0eAVFs\u6bd4\u8f83\uff0cAVGs\u589e\u52a0\u60a3\u8005\u5168\u56e0\u6b7b\u4ea1\uff08RR=1.18\uff0c95%CI\uff1a1.09~1.27\uff0cI2<\/sup>=80.9%\uff09\u548c\u81f4\u547d\u611f\u67d3\uff08RR=1.36\uff0c95%CI\uff1a1.17~1.58\uff0cI2<\/sup>=0\uff09\u7684\u98ce\u9669\uff3b48\uff3d<\/sup>\u3002<\/p>\n

\u63a8\u8350\u610f\u89c119\uff1a\u672a\u5efa\u7acbAVFs\u6025\u8bca\u884cHDF\u6cbb\u7597\uff0c\u6216HDF\u6cbb\u7597\u671f\u95f4\u8840\u7ba1\u901a\u8def\u5931\u529f\uff0c\u6216\u8179\u819c\u900f\u6790\u4e34\u65f6\u8f6c\u4e3aHDF\u6cbb\u7597\u65f6\uff0c\u53ef\u9009\u62e9\u65e0\u96a7\u9053\u65e0\u6da4\u7eb6\u5957\u4e2d\u5fc3\u9759\u8109\u5bfc\u7ba1\u3002\uff08D5\uff09<\/p>\n

HDF\u6cbb\u7597\u524d\u672a\u5efa\u7acbAVFs\u60a3\u8005\uff0c\u7531\u4e8e\u5fc3\u529b\u8870\u7aed\u3001\u80ba\u6c34\u80bf\u3001\u4e25\u91cd\u7535\u89e3\u8d28\u7d0a\u4e71\u3001\u5c3f\u6bd2\u75c7\u8111\u75c5\u6216\u6d88\u5316\u9053\u51fa\u8840\u7b49\u9700\u8981\u6025\u8bca\u900f\u6790\uff1b\u6216AVFs\u3001AVGs\u6216TCCs\u4e0d\u80fd\u63d0\u4f9b\u6ee1\u8db3\u900f\u6790\u5904\u65b9\u9700\u6c42\u7684\u8840\u6d41\u91cf\u6216\u56e0\u611f\u67d3\u7b49\u539f\u56e0\u65e0\u6cd5\u7ee7\u7eed\u4f7f\u7528\uff1b\u6216\u8179\u819c\u900f\u6790\u60a3\u8005\u7531\u4e8e\u4efb\u4f55\u539f\u56e0\u5fc5\u987b\u6682\u505c\u8179\u819c\u900f\u6790\uff0c\u9700\u8981\u8f6c\u4e3aHDF\u6cbb\u7597\u65f6\uff0c\u53ef\u7559\u7f6e\u65e0\u96a7\u9053\u65e0\u6da4\u7eb6\u5957\u4e2d\u5fc3\u9759\u8109\u5bfc\u7ba1\uff3b49\uff3d<\/sup>\u3002<\/p>\n

\u4e8c\u3001HDF\u8840\u7ba1\u901a\u8def\u7684\u4f7f\u7528\u4e0e\u7ef4\u62a4<\/p>\n

HDF\u8840\u7ba1\u901a\u8def\u7684\u5efa\u7acb\u6280\u672f\u4ee5\u53ca\u6cbb\u7597\u65f6\u8840\u7ba1\u901a\u8def\u7684\u4e0a\u4e0b\u673a\u5177\u4f53\u64cd\u4f5c\uff0c\u540c\u8840\u6db2\u900f\u6790\uff1b\u5e94\u4f9d\u636e\u300a\u8840\u6db2\u51c0\u5316\u6807\u51c6\u64cd\u4f5c\u89c4\u7a0b\uff082021\u7248\uff09\u300b\u8fdb\u884c\u5177\u4f53\u64cd\u4f5c\uff3b42\uff3d<\/sup>\u3002<\/p>\n

\u63a8\u8350\u610f\u89c120\uff1aAVFs\u672f\u524d\u548c\u672f\u540e\u5e94\u8bc4\u4f30AVFs\u4e0d\u6210\u719f\u7684\u4e34\u5e8a\u8868\u73b0\u548c\u57fa\u4e8e\u8d85\u58f0\u68c0\u67e5\u7684\u8840\u6d41\u52a8\u529b\u5b66\u98ce\u9669\uff0c\u5bf9\u4e8e\u672f\u540eAVFs\u4e0d\u6210\u719f\u5e94\u53ca\u65f6\u8fdb\u884c\u633d\u6551\u624b\u672f\u6216\u7403\u56ca\u8840\u7ba1\u6210\u5f62\u672f\uff1b\u4e0d\u5efa\u8bae\u4f7f\u7528\u7403\u56ca\u8840\u7ba1\u6210\u5f62\u672f\u8054\u5408\u526f\u9759\u8109\u95ed\u585e\u672f\u633d\u6551\u672a\u6210\u719fAVFs\u3002\uff08B2b\uff09<\/p>\n

\u672f\u524dAVFs\u4e0d\u6210\u719f\u98ce\u9669\u8bc4\u4f30\u53ca\u672f\u540e\u65e9\u671f\u8bc4\u4f30\u8840\u6d41\u52a8\u529b\u5b66\u53ef\u4ee5\u6709\u6548\u5730\u8bc6\u522b\u51fa\u6709AVFs\u4e0d\u6210\u719f\u98ce\u9669\u7684\u60a3\u8005\uff0c\u5e76\u901a\u8fc7\u65e9\u671f\u5e72\u9884\u5f97\u5230\u6709\u6548\u6cbb\u7597\u3002\u57fa\u4e8e33\u9879\u7814\u7a76\uff0821\u9879\u4e3aAVFs\u4e0d\u6210\u719f\u98ce\u9669\u5206\u6790\uff0c12\u9879\u4e3aAVFs\u4e0d\u6210\u719f\u5e72\u9884\uff09\u7684\u7cfb\u7edf\u7efc\u8ff0\u7ed3\u679c\u663e\u793a\uff0c\u5bf9\u4e8e\u65e9\u671fAVFs\u4e0d\u6210\u719f\u98ce\u9669\uff0c\u672f\u524d\u5177\u6709\u4e34\u5e8a\u5371\u9669\u56e0\u7d20\u60a3\u8005\u7684\u7edd\u5bf9\u98ce\u966921%\uff0895%CI\uff1a11%~30%\uff09\u548c\u76f8\u5bf9\u98ce\u96691.7\uff0895%CI\uff1a1.3~2.1\uff09\uff0c\u5177\u6709\u8840\u6d41\u52a8\u529b\u5b66\u5371\u9669\u56e0\u7d20\u60a3\u8005\u7684\u7edd\u5bf9\u98ce\u966950%\uff0895%CI\uff1a42%~58%\uff09\u548c\u76f8\u5bf9\u98ce\u96691.7\uff0895%CI\uff1a1.4~2.0\uff09\uff1b\u672f\u540e\u4e0d\u4e45\u51fa\u73b0\u8840\u6d41\u52a8\u529b\u5b66\u5371\u9669\u56e0\u7d20\u60a3\u8005\u7684\u7edd\u5bf9\u98ce\u966950%\uff0895%CI\uff1a42%~58%\uff09\u548c\u76f8\u5bf9\u98ce\u96694.3\uff0895%CI\uff1a3.4~5.5\uff09\uff1b\u5bf9\u4e8eAVFs\u4e0d\u6210\u719f\u60a3\u8005\uff0c\u65e9\u671f\u624b\u672f\u6cbb\u7597\u7684\u5e73\u5747\u6210\u529f\u738786%\uff0c1\u5e74\u521d\u7ea7\u901a\u7545\u738751%\uff0c\u5e76\u53d1\u75c7\u53d1\u751f\u73879.3%\uff1b86%\uff0895%CI\uff1a74%~98%\uff09\u7684AVFs\u4e0d\u6210\u719f\u60a3\u8005\uff0c\u53ef\u901a\u8fc7\u633d\u6551\u624b\u672f\u81f3\u5c11\u4f7f\u75281\u6b21AVFs\u8fdb\u884c\u8840\u6db2\u900f\u6790\uff0c1\u5e74\u5e73\u5747\u521d\u7ea7\u901a\u7545\u738751%\uff0895%CI\uff1a28%~68%\uff09\uff0c1\u5e74\u5e73\u5747\u6b21\u7ea7\u901a\u7545\u738776%\uff0895%CI\uff1a72%~95%\uff09\uff3b50\uff3d<\/sup>\u3002<\/p>\n

\u7403\u56ca\u8840\u7ba1\u6210\u5f62\u672f\u6216\u7403\u56ca\u8840\u7ba1\u6210\u5f62\u8054\u5408\u526f\u9759\u8109\u95ed\u585e\u672f\uff08\u7ecf\u8840\u7ba1\u5185\u5957\u5708\u6216\u5916\u79d1\u624b\u672f\u7ed3\u624e\uff09\u5747\u5177\u6709\u5f88\u597d\u7684\u6280\u672f\u6210\u529f\u7387\uff08\u6cbb\u7597\u540eAVFs\u8840\u6d41\u91cf>300 ml\/min\uff09\u548c\u4e34\u5e8a\u6210\u529f\u7387\uff08\u6cbb\u7597\u540eAVFs\u53ef\u5b8c\u62101\u6b21\u900f\u6790\uff09\u4ee5\u53ca\u663e\u8457\u76843\u30016\u4e2a\u6708\u521d\u7ea7\u901a\u7545\u7387\u548c3\u30016\u300112\u4e2a\u6708\u7684\u6b21\u7ea7\u901a\u7545\u7387\uff0c2\u79cd\u6280\u672f\u95f4\u65e0\u660e\u663e\u5dee\u522b\u3002\u4e00\u7bc7\u9488\u5bf914\u9879\u7814\u7a761 030\u4f8b\u5e94\u7528\u7403\u56ca\u8840\u7ba1\u6210\u5f62\u672f\u6216\u7403\u56ca\u8840\u7ba1\u6210\u5f62\u8054\u5408\u526f\u9759\u8109\u95ed\u585e\u672f\u62a2\u6551\u672a\u6210\u719fAVFs\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u7403\u56ca\u8840\u7ba1\u6210\u5f62\u672f\u6216\u7403\u56ca\u8840\u7ba1\u6210\u5f62\u8054\u5408\u526f\u9759\u8109\u95ed\u585e\u672f\u7684\u6280\u672f\u6210\u529f\u7387\uff0893.6%\u6bd493.4%\uff09\u548c\u4e34\u5e8a\u6210\u529f\u7387\uff0892.4%\u6bd488.1%\uff09\u65e0\u660e\u663e\u5dee\u522b\uff0c3\u4e2a\u6708\uff0875.2%\u6bd475.7%\uff09\u30016\u4e2a\u6708\uff0867.6%\u6bd458.4%\uff09\u548c12\u4e2a\u6708\uff0861.4%\u6bd452.7%\uff09\u7684\u521d\u7ea7\u901a\u7545\u7387\u65e0\u660e\u663e\u5dee\u522b\uff0c3\u4e2a\u6708\uff0891.2%\u6bd492.9%\uff09\u30016\u4e2a\u6708\uff0886.3%\u6bd490.0%\uff09\u548c12\u4e2a\u6708\uff0880.1%\u6bd483.1%\uff09\u7684\u6b21\u7ea7\u901a\u7545\u7387\u65e0\u660e\u663e\u5dee\u522b\uff3b51\uff3d<\/sup>\u3002<\/p>\n

\u63a8\u8350\u610f\u89c121\uff1a\u63a8\u8350AVFs\u4f7f\u7528\u7ef3\u68af\u5f0f\u6216\u6263\u773c\u5f0f\u7a7f\u523a\u65b9\u6cd5\u3002\uff08B2a\uff09<\/p>\n

\u4f7f\u7528AVFs\u8fdb\u884c\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u768411\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u548c4\u9879\u8fde\u7eed\u5bf9\u7167\u8bd5\u9a8c\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u7ef3\u68af\u5f0f\u7a7f\u523a\u6bd4\u8f83\uff0c\u6263\u773c\u5f0f\u7a7f\u523a\u663e\u8457\u51cf\u5c11\u4e86\u52a8\u8109\u7624\u5f62\u6210\uff08RR=0.18\uff0c95%CI\uff1a0.1~0.32\uff0cI2<\/sup>=12%\uff09\u3001\u72ed\u7a84\uff08RR=0.44\uff0c95%CI\uff1a0.25~0.77\uff0cI2<\/sup>=21%\uff09\u3001\u8840\u6813\u5f62\u6210\uff08RR=0.4\uff0c95%CI\uff1a0.2~0.8\uff0cI2<\/sup>=0\uff09\u548c\u8840\u80bf\uff08RR=0.63\uff0c95%CI\uff1a0.40~0.99\uff0cI2<\/sup>=51%\uff09\uff1b\u4f46\u22646\u4e2a\u6708\u548c>6\u4e2a\u6708\u7684\u8840\u7ba1\u901a\u8def\u611f\u67d3\u4ee5\u53caAVFs\u5b58\u6d3b\u7387\u5747\u65e0\u660e\u663e\u5dee\u522b\uff3b52\uff3d<\/sup>\u3002<\/p>\n

\u63a8\u8350\u610f\u89c122\uff1a\u57fa\u4e8e\u8840\u6d41\u6d4b\u91cf\u6216\u591a\u666e\u52d2\u8d85\u58f0\u7b5b\u67e5\u7684\u9884\u9632\u6027\u5e72\u9884\uff0c\u53ef\u663e\u8457\u51cf\u5c11\u8840\u7ba1\u901a\u8def\u7684\u8840\u6813\u5f62\u6210\u3002\uff08A1a\uff09<\/p>\n

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\u63a8\u8350\u610f\u89c123\uff1a\u8fdc\u7ea2\u5916\u7ebf\u6cbb\u7597\u53ef\u6539\u5584AVFs\u7684\u901a\u7545\u7387\uff0c\u5e76\u964d\u4f4e\u60a3\u8005\u9488\u523a\u75bc\u75db\u7684\u7a0b\u5ea6\u3002\uff08B2a\uff09<\/p>\n

\u4e00\u7bc7\u9488\u5bf921\u9879\u968f\u673a\/\u51c6\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7684960\u4f8b\u63a5\u53d7\u7ea2\u5916\u7ebf\u6cbb\u7597\u548c939\u4f8b\u63a5\u53d7\u5b89\u6170\u5242\u6cbb\u7597\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u7ea2\u5916\u7ebf\u6cbb\u7597\u53ef\u663e\u8457\u589e\u52a0\u8840\u7ba1\u901a\u8def\u7684\u8840\u6d41\u91cf\uff08MD=81.69 ml\/min\uff0c95%CI\uff1a46.17~117.21\uff0cI2<\/sup>=86%\uff09\u3001AVFs\u76f4\u5f84\uff08MD=0.36 mm\uff0c95%CI\uff1a0.22~0.51\uff0cI2<\/sup>=68%\uff09\u53ca\u5176\u521d\u7ea7\u901a\u7545\u7387\uff08RR=1.24\uff0c95%CI\uff1a1.12~1.37\uff0cI2<\/sup>=0\uff09\uff0c\u663e\u8457\u964d\u4f4eAVFs\u95ed\u585e\u7387\uff08RR=0.20\uff0c95%CI\uff1a0.08~0.46\uff0cI2<\/sup>=0\uff09\u548c\u9488\u523a\u75bc\u75db\u7a0b\u5ea6\uff08RR=0.08\uff0c95%CI\uff1a0.06~0.10\uff0cI2<\/sup>=99%\uff09\uff3b54\uff3d<\/sup>\u3002<\/p>\n

\u63a8\u8350\u610f\u89c124\uff1a\u63a8\u8350\u4f7f\u7528\u4f4e\u6d53\u5ea6\uff081 000 U\/ml\uff09\u809d\u7d20\u548c\u4f4e\u6d53\u5ea6\uff08<5%\uff09\u67b8\u6a7c\u9178\u94a0\u5c01\u7ba1\u6db2\u3002\uff08A1a\uff09<\/p>\n

\u57fa\u4e8e5\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u548c3\u9879\u5bf9\u7167\u7814\u7a76916\u4f8b\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u9ad8\u5242\u91cf\uff08\u22655 000 U\/ml\uff09\u809d\u7d20\u6bd4\u8f83\uff0c\u4f4e\u5242\u91cf\uff08<5 000 U\/ml\uff09\u809d\u7d20\u5c01\u7ba1\u53ef\u4ee5\u663e\u8457\u964d\u4f4e\u51fa\u8840\u76f8\u5173\u5e76\u53d1\u75c7\u7684\u53d1\u751f\u7387\uff08RR=3.29\uff0c95%CI\uff1a2.19~4.94\uff09\u548c\u5bfc\u7ba1\u76f8\u5173\u611f\u67d3\u53d1\u751f\u7387\uff08RR=1.66\uff0c95%CI\uff1a1.01~2.73\uff09\uff1b\u5bfc\u7ba1\u5b58\u6d3b\u65f6\u95f4\u4ee5\u53ca\u5bfc\u7ba1\u8840\u6813\u5f62\u6210\/\u95ed\u585e\u6216\u5bfc\u7ba1\u529f\u80fd\u969c\u788d\u53d1\u751f\u7387\u5747\u65e0\u660e\u663e\u5dee\u522b\uff3b55\uff3d<\/sup>\u3002184\u4f8b\u968f\u673a\u5bf9\u7167\u7814\u7a76\u7ed3\u679c\u8bc1\u5b9e\uff0c\u4e0e1 000 U\/ml\u809d\u7d20\u6bd4\u8f83\uff0c5 000 U\/ml\u809d\u7d20\u5c01\u7ba1\u7684\u529f\u80fd\u5b58\u6d3b\u65f6\u95f4\u3001\u5bfc\u7ba1\u95ed\u585e\u7387\u548c\u611f\u67d3\u7387\u65e0\u660e\u663e\u5dee\u522b\uff1b\u4f46\u663e\u8457\u5ef6\u957f\u5c01\u7ba1\u540e10 min\u7684\u6d3b\u5316\u90e8\u5206\u51dd\u8840\u6d3b\u9176\u65f6\u95f4\uff08APTT\uff09\uff3b\uff0830.1\u00b134.4\uff09s\u6bd4\uff0832.2\u00b15.0\uff09s\uff0cP<0.05\uff3d\uff0c\u663e\u8457\u589e\u52a0\u4f34\u6709\u8840\u6d41\u52a8\u529b\u5b66\u53d8\u5316\u7684\u5927\u51fa\u8840\u53d1\u751f\u7387\uff089.5%\u6bd41.1%\uff0cP<0.05\uff09\u548c\u7ea2\u7ec6\u80de\u6bd4\u5bb9\u4e0b\u964d\u901f\u7387\uff3b\uff08-2.30\u00b11.73\uff09%\/d\u6bd4\uff08-1.37\u00b11.82\uff09%\/d\uff0cP<0.05\uff3d\uff3b56\uff3d<\/sup>\u3002<\/p>\n

\u57fa\u4e8e13\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c1 770\u4f8b\u60a3\u8005221 064\u4e2a\u5bfc\u7ba1\u65e5\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u809d\u7d20\u5c01\u7ba1\u6bd4\u8f83\uff0c1.04%~4%\u67b8\u6a7c\u9178\u94a0\u5c01\u7ba1\uff08RR=0.38\uff0c95%CI\uff1a0.25~0.58\uff0cI2<\/sup>=10%\uff09\u548c4.6%~7%\u67b8\u6a7c\u9178\u94a0\u5c01\u7ba1\uff08RR=0.27\uff0c95%CI\uff1a0.12~0.64\uff0cI2<\/sup>=0\uff09\u7684\u5bfc\u7ba1\u76f8\u5173\u8840\u6d41\u611f\u67d3\u53d1\u751f\u7387\u663e\u8457\u964d\u4f4e\uff0c\u4f4630%~46.7%\u67b8\u6a7c\u9178\u94a0\u65e0\u660e\u663e\u5dee\u522b\uff08RR=0.50\uff0c95%CI\uff1a0.14~1.83\uff0cI2<\/sup>=83%\uff09\uff1b\u4e0e\u809d\u7d20\u5c01\u7ba1\u6bd4\u8f83\uff0c\u67b8\u6a7c\u9178\u94a0\u5c01\u7ba1\u663e\u8457\u964d\u4f4e\u51fa\u8840\u4e8b\u4ef6\u53d1\u751f\u7387\uff08RR=0.48\uff0c95%CI\uff1a0.30~0.76\uff09\uff0c\u4f46\u51fa\u53e3\u90e8\u4f4d\u611f\u67d3\u3001\u79fb\u9664\u5bfc\u7ba1\u3001\u6eb6\u6813\u6cbb\u7597\u3001\u5168\u56e0\u6b7b\u4ea1\u3001\u5bfc\u7ba1\u8840\u6813\u5f62\u6210\u3001\u5e73\u5747\u5bfc\u7ba1\u751f\u5b58\u65f6\u95f4\u53ca\u65e0\u5bfc\u7ba1\u76f8\u5173\u8840\u6d41\u611f\u67d3\u7684\u5bfc\u7ba1\u5b58\u6d3b\u7387\u53ca\u5bfc\u7ba1\u76f8\u5173\u518d\u5165\u9662\u7387\u5747\u65e0\u660e\u663e\u5dee\u522b\uff3b57\uff3d<\/sup>\u3002<\/p>\n

\u63a8\u8350\u610f\u89c125\uff1a\u5bf9\u4e8e\u9ad8\u5371\/\u5408\u5e76\u5bfc\u7ba1\u529f\u80fd\u969c\u788d\u60a3\u8005\uff0c\u63a8\u8350\u91cd\u7ec4\u7ec4\u7ec7\u578b\u7ea4\u6eb6\u9176\u539f\u6fc0\u6d3b\u5242\uff08rt-PA\uff09\u5c01\u7ba1\uff1b\u5bf9\u4e8e\u9ad8\u5371\/\u5408\u5e76\u5bfc\u7ba1\u76f8\u5173\u611f\u67d3\u60a3\u8005\uff0c\u63a8\u8350\u6297\u51dd\u5242\u8054\u5408\u6297\u751f\u7d20\/\u6297\u83cc\u5242\u5c01\u7ba1\uff0c\u53ef\u8003\u8651\u4f18\u5148\u9009\u62e9\u67b8\u6a7c\u9178\u94a0+\u5e86\u5927\u9709\u7d20\u3002\uff08A1a\uff09<\/p>\n

\u4e00\u7bc7\u9488\u5bf928\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c3 081\u4f8b\u4f7f\u7528\u4e2d\u5fc3\u9759\u8109\u5bfc\u7ba1\u7684\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c5 000 U\/ml\u809d\u7d20\u662f\u5bf9\u7167\u7ec4\u6700\u5e38\u4f7f\u7528\u7684\u5c01\u7ba1\u6db2\uff0818\/28\u9879\u8bd5\u9a8c\uff09\uff1b\u4e0e\u5bf9\u7167\u7ec4\u6bd4\u8f83\uff0crt-PA\u5c01\u7ba1\u6db2\u663e\u8457\u964d\u4f4e\u5bfc\u7ba1\u529f\u80fd\u969c\u788d\uff08RR=0.58\uff0c95%CI\uff1a0.37~0.91\uff09\uff1b\u800c\u67b8\u6a7c\u9178\u94a0\u3001\u53e3\u670d\u534e\u6cd5\u6797\u3001\u8054\u5408\u6297\u751f\u7d20\/\u6297\u83cc\u5242\u5c01\u7ba1\u6db2\u548c\u4f4e\u5242\u91cf\/\u65e0\u809d\u7d20\u5c01\u7ba1\u6db2\u5747\u4e0d\u5f71\u54cd\u5bfc\u7ba1\u529f\u80fd\u969c\u788d\u53d1\u751f\u7387\uff1b\u67b8\u6a7c\u9178\u94a0\uff08RR=0.49\uff0c95%CI\uff1a0.34~0.72\uff0cI2<\/sup>=32.7%\uff09\u3001\u6297\u751f\u7d20\/\u6297\u83cc\u5242\uff08RR=0.27\uff0c95%CI\uff1a0.11~0.70\uff09\u548crt-PA\uff08RR=0.35\uff0c95%CI\uff1a0.13~0.93\uff09\u5c01\u7ba1\u6db2\u5747\u53ef\u663e\u8457\u51cf\u5c11\u5bfc\u7ba1\u76f8\u5173\u83cc\u8840\u75c7\uff0c\u800c\u53e3\u670d\u534e\u6cd5\u6797\u5168\u8eab\u6297\u51dd\u548c\u4f4e\u5242\u91cf\/\u65e0\u809d\u7d20\u5c01\u7ba1\u6db2\u65e0\u660e\u663e\u6548\u679c\uff1brt-PA\u5c01\u7ba1\u6db2\u663e\u8457\u51cf\u5c11\u62a2\u6551\u6027\u6eb6\u6813\u836f\u7269\u7684\u4f7f\u7528\uff08RR=0.21\uff0c95%CI\uff1a0.07~0.59\uff09\uff0c\u800c\u67b8\u6a7c\u9178\u94a0\u65e0\u660e\u663e\u4f5c\u7528\uff1b\u4f7f\u7528rt-PA\u5c01\u7ba1\u6db2\u548c\u534e\u6cd5\u6797\u7684\u51fa\u8840\u4e8b\u4ef6\u65e0\u660e\u663e\u5dee\u522b\uff3b58\uff3d<\/sup>\u3002<\/p>\n

\u57fa\u4e8e18\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c2 395\u4f8b\u4e2d\u5fc3\u9759\u8109\u5bfc\u7ba1\u7684\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u8d1d\u53f6\u65af\u7f51\u7edc\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u809d\u7d20\u76f8\u6bd4\uff0c\u5e86\u5927\u9709\u7d20\u8054\u5408\u67b8\u6a7c\u9178\u94a0\uff08OR=0.07\uff0c95%CI\uff1a0~0.48\uff09\u548c\u5e86\u5927\u9709\u7d20\u8054\u5408\u809d\u7d20\uff08OR=0.04\uff0c95%CI\uff1a0~0.23\uff09\u5c01\u7ba1\u663e\u8457\u964d\u4f4e\u5bfc\u7ba1\u76f8\u5173\u8840\u6d41\u611f\u67d3\uff0c\u800c\u7c73\u8bfa\u73af\u7d20+\u4e59\u4e8c\u80fa\u56db\u4e59\u9178\uff08EDTA\uff09\u3001\u4e59\u9187\u3001\u67b8\u6a7c\u9178\u94a0\u3001\u5934\u5b62\u567b\u809f+\u809d\u7d20\u3001\u725b\u78fa\u7f57\u5b9a+\u67b8\u6a7c\u9178\u94a0\u3001\u4e07\u53e4\u9709\u7d20+\u809d\u7d20\u53ca\u5934\u5b62\u5511\u6797+\u67b8\u6a7c\u9178\u94a0\u5c01\u7ba1\u6db2\u65e0\u660e\u663e\u5dee\u522b\uff1b\u7c73\u8bfa\u73af\u7d20+EDTA\u3001\u5e86\u5927\u9709\u7d20+\u67b8\u6a7c\u9178\u94a0\u3001\u67b8\u6a7c\u9178\u94a0\u3001\u5e86\u5927\u9709\u7d20+\u809d\u7d20\u3001\u725b\u78fa\u7f57\u5b9a+\u67b8\u6a7c\u9178\u94a0\u53ca\u4e07\u53e4\u9709\u7d20+\u809d\u7d20\u7684\u51fa\u53e3\u90e8\u4f4d\u611f\u67d3\u65e0\u660e\u663e\u5dee\u522b\uff1b\u7c73\u8bfa\u73af\u7d20+EDTA\u3001\u5e86\u5927\u9709\u7d20+\u67b8\u6a7c\u9178\u94a0\u3001\u67b8\u6a7c\u9178\u94a0\u53ca\u5e86\u5927\u9709\u7d20+\u809d\u7d20\u7684\u5168\u56e0\u6b7b\u4ea1\u7387\u65e0\u660e\u663e\u5dee\u522b\uff3b59\uff3d<\/sup>\u3002<\/p>\n

\u4e09\u3001\u8840\u7ba1\u901a\u8def\u7684\u533b\u7597\u8d28\u91cf\u63a7\u5236\u6307\u6807<\/p>\n

\u63a8\u8350\u610f\u89c126\uff1a\u5efa\u8baeHDF\u8840\u7ba1\u901a\u8def\u6309\u4ee5\u4e0b\u6307\u6807\u8fdb\u884c\u533b\u7597\u8d28\u91cf\u63a7\u5236\u3002\uff08D5\uff09<\/p>\n

1. HDF\u60a3\u8005\u8840\u7ba1\u901a\u8def\u5efa\u7acb\u524d\u8840\u7ba1\u6761\u4ef6\u548c\u5168\u8eab\u72b6\u6001\u8bc4\u4f30\u5b8c\u6210\u7387\uff1a\u8840\u7ba1\u901a\u8def\u5efa\u7acb\u524d\u5b8c\u6210\u8840\u7ba1\u6761\u4ef6\u548c\u5168\u8eab\u72b6\u6001\u8bc4\u4f30\u7684\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

2. HDF\u60a3\u8005AVFs\u4f7f\u7528\u7387\uff1aHDF\u6cbb\u7597\u60a3\u8005\u4e2d\u4f7f\u7528AVFs\u7684\u60a3\u8005\u6bd4\u4f8b\u3002<\/p>\n

3. AVFs\u957f\u671f\u751f\u5b58\u7387\uff1aHDF\u6cbb\u7597\u60a3\u8005\u4e2d\u540c\u4e00\u52a8\u9759\u8109\u5185\u7618\u6301\u7eed\u4f7f\u7528\u65f6\u95f4>2\u5e74\u7684\u60a3\u8005\u6bd4\u4f8b\u3002<\/p>\n

\u7b2c\u516d\u90e8\u5206 \u6297\u51dd\u6cbb\u7597<\/p>\n

HDF\u7684\u6297\u51dd\u6cbb\u7597\u65b9\u6cd5\u4e0e\u8840\u6db2\u900f\u6790\u57fa\u672c\u76f8\u540c\uff0c\u5e94\u9075\u5faa\u300a\u8840\u6db2\u51c0\u5316\u6807\u51c6\u64cd\u4f5c\u89c4\u7a0b\uff082021\u7248\uff09\u300b\uff3b42\uff3d<\/sup>\u3002<\/p>\n

\u4e00\u3001\u51dd\u8840\u72b6\u6001\u7684\u8bc4\u4f30\u4e0e\u76d1\u6d4b<\/p>\n

\u63a8\u8350\u610f\u89c127\uff1aHDF\u6cbb\u7597\u524d\u5e94\u8bc4\u4f30\u60a3\u8005\u7684\u51dd\u8840\u72b6\u6001\u4ee5\u53ca\u51fa\u8840\u6216\u8840\u6813\u6813\u585e\u75be\u75c5\u7684\u98ce\u9669\uff0c\u6307\u5bfc\u6297\u51dd\u5242\u7684\u9009\u62e9\uff1b\u9996\u6b21HDF\u6cbb\u7597\u65f6\u901a\u8fc7\u8bc4\u4f30\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u4f53\u5916\u5faa\u73af\u548c\u60a3\u8005\u4f53\u5185\u51dd\u8840\u72b6\u6001\uff0c\u4ee5\u53ca\u6cbb\u7597\u7ed3\u675f\u65f6\u60a3\u8005\u4f53\u5185\u51dd\u8840\u72b6\u6001\uff0c\u8c03\u6574\u6297\u51dd\u5242\u5242\u91cf\uff1b\u5e76\u901a\u8fc7\u5b9a\u671f\u51dd\u8840\u72b6\u6001\u8bc4\u4f30\uff0c\u8c03\u6574\u6297\u51dd\u5242\u4f7f\u7528\u3002\uff08D5\uff09<\/p>\n

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1. \u8bc4\u4f30\u5185\u5bb9\uff1a\uff081\uff09\u4f9d\u636e\u60a3\u8005\u7684\u65e2\u5f80\u75c5\u53f2\u3001\u4e34\u5e8a\u7279\u5f81\u548c\u6297\u51dd\u836f\u7269\u7684\u4f7f\u7528\u60c5\u51b5\uff0c\u8bc4\u4f30\u60a3\u8005\u662f\u5426\u5b58\u5728\u51fa\u8840\u6216\u8840\u6813\u6813\u585e\u7684\u98ce\u9669\uff1b\uff082\uff09\u901a\u8fc7\u5b9e\u9a8c\u5ba4\u68c0\u6d4b\u8bc4\u4f30\u60a3\u8005\u7684\u5185\u6e90\u6027\u3001\u5916\u6e90\u6027\u548c\u51dd\u8840\u5171\u540c\u9014\u5f84\u72b6\u6001\uff0c\u4ee5\u53ca\u8840\u5c0f\u677f\u529f\u80fd\u548c\u7ea4\u6eb6\u6d3b\u6027\u72b6\u6001\uff0c\u660e\u786e\u60a3\u8005\u7684\u51fa\u8840\u6216\u8840\u6813\u6813\u585e\u98ce\u9669\u3002<\/p>\n

2. \u8bc4\u4f30\u6307\u6807\uff1a\u5efa\u8bae\u5e38\u89c4\u68c0\u6d4bAPTT\u6216\u6d3b\u5316\u51dd\u8840\u65f6\u95f4\uff08ACT\uff09\u3001\u51dd\u8840\u9176\u539f\u65f6\u95f4\uff08PT\uff09\u6216\u56fd\u9645\u6807\u51c6\u5316\u6bd4\u503c\uff08INR\uff09\u3001\u7ea4\u7ef4\u86cb\u767d\u539f\u3001\u5168\u8840\u8840\u5c0f\u677f\u8ba1\u6570\u53caD-\u4e8c\u805a\u4f53\uff0c\u6709\u6761\u4ef6\u7684\u5355\u4f4d\u5efa\u8bae\u5e38\u89c4\u68c0\u6d4b\u6297\u51dd\u8840\u9176\u6d3b\u6027\u3002<\/p>\n

\uff08\u4e8c\uff09\u9996\u6b21HDF\u6cbb\u7597\u65f6\u51dd\u8840\u72b6\u6001\u7684\u76d1\u6d4b<\/p>\n

1. \u76d1\u6d4b\u5185\u5bb9\uff1a\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u4eceHDF\u7ba1\u8def\u7684\u9759\u8109\u7aef\u91c7\u8840\uff0c\u8bc4\u4f30\u4f53\u5916\u5faa\u73af\u7684\u51dd\u8840\u72b6\u6001\uff0c\u660e\u786e\u6297\u51dd\u6cbb\u7597\u6709\u6548\u6027\uff1b\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u4eceHDF\u7ba1\u8def\u52a8\u8109\u7aef\u6216\u60a3\u8005\u9759\u8109\u91c7\u8840\uff0c\u4ee5\u53ca\u6cbb\u7597\u7ed3\u675f\u65f6\u4ece\u60a3\u8005\u9759\u8109\u91c7\u8840\uff0c\u8bc4\u4f30\u60a3\u8005\u4f53\u5185\u51dd\u8840\u72b6\u6001\uff0c\u660e\u786e\u6297\u51dd\u6cbb\u7597\u5b89\u5168\u6027\u3002<\/p>\n

2. \u76d1\u6d4b\u6307\u6807\uff1a\u4f9d\u636e\u9009\u62e9\u4f7f\u7528\u6297\u51dd\u5242\uff1a\uff081\uff09\u666e\u901a\u809d\u7d20\uff1aACT\uff1b\uff082\uff09\u4f4e\u5206\u5b50\u809d\u7d20\uff1a\u6297\u51dd\u8840\u56e0\u5b50\u2169a\u6d3b\u6027\uff1b\uff083\uff09\u963f\u52a0\u66f2\u73ed\u6216\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\uff1aAPTT\uff1b\uff084\uff09\u67b8\u6a7c\u9178\u5c40\u90e8\u6297\u51dd\uff1aAPTT\u6216PT\u3001\u6e38\u79bb\u9499\u4ee5\u53ca\u60a3\u8005\u8840\u6db2\u603b\u9499\/\u6e38\u79bb\u9499\u6bd4\u503c\u3001\u94a0\u79bb\u5b50\u3001\u78b3\u9178\u6c22\u76d0\u548c\u4e8c\u6c27\u5316\u78b3\u6c34\u5e73\u3002<\/p>\n

\uff08\u4e09\uff09\u51dd\u8840\u72b6\u6001\u7684\u5b9a\u671f\u8bc4\u4f30<\/p>\n

\u6bcf\u6b21HDF\u6cbb\u7597\u7ed3\u675f\u540e\u89c6\u89c9\u51dd\u8840\u6307\u6807\u8bc4\u4f30\uff1a\u6839\u636e\u6bcf\u6b21HDF\u6cbb\u7597\u7ed3\u675f\u540e\u900f\u6790\u7ba1\u8def\u3001\u900f\u6790\u5668\/\u8840\u6ee4\u5668\u7684\u76ee\u6d4b\u51dd\u8840\u60c5\u51b5\u4ee5\u53ca\u7a7f\u523a\u70b9\u7684\u6b62\u8840\u65f6\u95f4\u7b49\uff0c\u7ecf\u9a8c\u6027\u8c03\u6574\u6297\u51dd\u5242\u5242\u91cf\uff0c\u5177\u6709\u5b9e\u65f6\u3001\u7b80\u5355\u3001\u6613\u884c\u7684\u7279\u70b9\u300289\u4e2a\u900f\u6790\u4e2d\u5fc3\u6d89\u53ca6 093\u4f8b\u900f\u6790\u60a3\u8005\u7684\u6a2a\u65ad\u9762\u89c2\u5bdf\u6027\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u8c03\u6574\u666e\u901a\u809d\u7d20\u6216\u4f4e\u5206\u5b50\u809d\u7d20\u7684\u5242\u91cf\u8c03\u6574\u65b9\u6cd5\u4e3a\u4f53\u5916\u5faa\u73af\u56de\u8def\u51dd\u8840\uff0888.2%\u7684\u4e2d\u5fc3\uff09\u3001\u56de\u8840\u540e\u7a7f\u523a\u90e8\u4f4d\u51fa\u8840\uff0875.3%\u7684\u4e2d\u5fc3\uff09\u4ee5\u53ca\u60a3\u8005\u4f53\u91cd\uff0857.6%\u7684\u4e2d\u5fc3\uff09\uff3b61\uff3d<\/sup>\u300237\u5bb6\u8840\u6db2\u900f\u6790\u4e2d\u5fc32 829\u4f8b\u540e\u7a00\u91caon-line HDF\u6cbb\u7597\u60a3\u8005\u7684\u591a\u4e2d\u5fc3\u56de\u987e\u6027\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u76ee\u6d4b\u4e3a\u6d01\u51c0\u900f\u6790\u5668\u7684\u60a3\u8005\u900f\u6790\u5145\u5206\u6027\u663e\u8457\u9ad8\u4e8e\u5176\u4ed6\u7c7b\u522b\u900f\u6790\u5668\uff1b\u76ee\u6d4b\u8bc4\u4f30\u900f\u6790\u7ed3\u675f\u540e\u7684\u900f\u6790\u5668\u72b6\u6001\u662f\u5e2e\u52a9\u533b\u5e08\u786e\u5b9a\u7406\u60f3\u809d\u7d20\u5242\u91cf\u7684\u7edd\u4f73\u673a\u4f1a\uff0c\u5e76\u5efa\u7acb\u4e86\u900f\u6790\u5668\u548c\u7ba1\u8def\u51dd\u8840\u72b6\u6001\u7684\u5206\u7ea7\u65b9\u6cd5\uff08\u56fe1\u30012\uff09\uff3b62\uff3d<\/sup>\u3002<\/p>\n

\u56fe1 \u900f\u6790\u5668\u51dd\u8840\u7a0b\u5ea6\u5206\u7ea7<\/p>\n

\u56fe2 \u7ba1\u8def\u9759\u8109\u58f6\u51dd\u8840\u72b6\u6001\u5206\u7ea7<\/p>\n

HDF\u6cbb\u7597\u7ed3\u675f\u540e\u51fa\u73b0\u663e\u8457\u7684\u900f\u6790\u5668\/\u8840\u6ee4\u5668\u51dd\u8840\uff0c\u4ee5\u53ca\u8840\u6813\u6813\u585e\u6216\u51fa\u8840\u6027\u75be\u75c5\uff0c\u5e94\u91cd\u65b0\u8bc4\u4f30\u60a3\u8005HDF\u6cbb\u7597\u524d\u3001\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u3001\u6cbb\u7597\u7ed3\u675f\u540e\u7684\u51dd\u8840\u72b6\u6001\uff08\u8bc4\u4f30\u6307\u6807\u540c\u4e0a\uff09\uff0c\u8c03\u6574\u6297\u51dd\u5242\u7684\u79cd\u7c7b\u548c\u5242\u91cf\u3002<\/p>\n

\u7ef4\u6301\u6027HDF\u6cbb\u7597\u60a3\u8005\uff0c\u5efa\u8bae\u81f3\u5c11\u6bcf3\u4e2a\u6708\u8bc4\u4f301\u6b21\u60a3\u8005HDF\u6cbb\u7597\u524d\u3001\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u3001\u6cbb\u7597\u7ed3\u675f\u540e\u7684\u51dd\u8840\u72b6\u6001\uff08\u8bc4\u4f30\u6307\u6807\u540c\u4e0a\uff09\uff0c\u8c03\u6574\u6297\u51dd\u5242\u7684\u79cd\u7c7b\u548c\u5242\u91cf\u3002<\/p>\n

\u4e8c\u3001\u6297\u51dd\u5242\u7684\u9009\u62e9<\/p>\n

\u63a8\u8350\u610f\u89c128\uff1a\u6297\u51dd\u5242\u7684\u9009\u62e9\u5e94\u9996\u5148\u9664\u5916\u6297\u51dd\u5242\u4f7f\u7528\u7981\u5fcc\u8bc1\uff1b\u6d3b\u52a8\u6027\u51fa\u8840\u6216\u9ad8\u5371\u51fa\u8840\u98ce\u9669\u3001\u65e2\u5f80\u666e\u901a\u809d\u7d20\u6216\u4f4e\u5206\u5b50\u809d\u7d20\u8fc7\u654f\u53f2\u6216\u809d\u7d20\u8bf1\u5bfc\u7684\u8840\u5c0f\u677f\u51cf\u5c11\u75c7\u75c5\u53f2\u7684\u60a3\u8005\u7981\u7528\u666e\u901a\u809d\u7d20\u6216\u4f4e\u5206\u5b50\u809d\u7d20\uff08A1a\uff09\uff1b\u5408\u5e76\u4e25\u91cd\u809d\u529f\u80fd\u969c\u788d\u6216\u65b0\u751f\u513f\u9176\u7cfb\u7edf\u53d1\u80b2\u4e0d\u5168\u7684\u60a3\u8005\u7981\u7528\u67b8\u6a7c\u9178\u94a0\uff0c\u5408\u5e76\u4e25\u91cd\u809d\u529f\u80fd\u969c\u788d\u60a3\u8005\u7981\u7528\u963f\u52a0\u66f2\u73ed\uff0c\u65e2\u5f80\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u8fc7\u654f\u60a3\u8005\u7981\u7528\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\uff08D5\uff09\u3002<\/p>\n

\u4e00\u9879\u57fa\u4e8e23\u9879\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7684\u7cfb\u7edf\u7efc\u8ff0\u4e0e\u835f\u8403\u5206\u6790\u4e2d\uff0c\u666e\u901a\u809d\u7d20\u4e0e\u4f4e\u5206\u5b50\u809d\u7d20\u4f53\u5916\u5faa\u73af\u8840\u6813\u5371\u9669\u6bd4\u4e3a1.00\uff0895%CI\uff1a0.62~1.62\uff09\uff0c\u51fa\u8840\u5e76\u53d1\u75c7\u5371\u9669\u6bd4\u4e3a1.16\uff0895%CI\uff1a0.62~2.15\uff09\uff0c\u65e0\u660e\u663e\u5dee\u522b\uff3b63\uff3d<\/sup>\u300215\u9879\u968f\u673a\/\u975e\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c7 287\u4f8b\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u809d\u7d20\u8bf1\u5bfc\u7684\u8840\u5c0f\u677f\u51cf\u5c11\u75c7\uff08HIT\uff09\u53d1\u751f\u7387\uff0c\u666e\u901a\u809d\u7d20\u6cbb\u7597\u65f6\u4e3a1.5%~3.8%\uff0c\u4f4e\u5206\u5b50\u809d\u7d20\u6cbb\u7597\u65f6\u4e3a0.1%~0.4%\uff1b\u4f4e\u5206\u5b50\u809d\u7d20\u663e\u8457\u4f4e\u4e8e\u666e\u901a\u809d\u7d20\uff3b64\uff3d<\/sup>\u3002\u6b64\u5916\uff0c\u666e\u901a\u809d\u7d20\u548c\u4f4e\u5206\u5b50\u809d\u7d20\u5747\u5177\u6709\u53d1\u751f\u8fc7\u654f\u7684\u98ce\u9669\uff1b\u6297\u51dd\u8840\u9176\u6d3b\u6027<50%\u65f6\uff0c\u666e\u901a\u809d\u7d20\u6216\u4f4e\u5206\u5b50\u809d\u7d20\u7684\u6297\u51dd\u4f5c\u7528\u663e\u8457\u964d\u4f4e\uff0c\u4e0d\u5efa\u8bae\u9009\u62e9\u5e94\u7528\u3002<\/p>\n

\u5b9e\u65bd\u5c40\u90e8\u67b8\u6a7c\u9178\u94a0\u6297\u51dd\u6cbb\u7597\u65f6\uff0c\u900f\u6790\u5668\/\u6ee4\u5668\u524d\u7ed9\u4e88\u7684\u67b8\u6a7c\u9178\u94a0\u548c\u900f\u6790\u5668\/\u6ee4\u5668\u540e\u8865\u5145\u7684\u9499\u76d0\uff0c\u5747\u5c06\u8fdb\u5165\u4f53\u5185\u7ecf\u809d\u810f\u3001\u80be\u810f\u548c\u808c\u8089\u4ee3\u8c22\u4e3a\u78b3\u9178\u6c22\u76d0\u548c\u9499\u76d0\uff0c\u8fdb\u800c\u78b3\u9178\u6c22\u76d0\u5206\u89e3\u4e3a\u4e8c\u6c27\u5316\u78b3\u548c\u6c34\uff0c\u7ecf\u80ba\u810f\u548c\u80be\u810f\/\u8840\u6db2\u51c0\u5316\u6cbb\u7597\u6392\u9664\u3002\u5408\u5e76\u4e25\u91cd\u809d\u529f\u80fd\u969c\u788d\u6216\u65b0\u751f\u513f\u9176\u7cfb\u7edf\u53d1\u80b2\u4e0d\u5168\u7684\u60a3\u8005\u4e0d\u80fd\u4ee3\u8c22\u67b8\u6a7c\u9178\u94a0\uff0c\u5408\u5e76\u80ba\u529f\u80fd\u969c\u788d\u7684\u60a3\u8005\u5219\u53ef\u5bfc\u81f4\u4e8c\u6c27\u5316\u78b3\u6f74\u7559\u3002\u5408\u5e76\u4f4e\u6c27\u8840\u75c7\uff08\u52a8\u8109\u6c27\u5206\u538b<60 mmHg\uff0c1 mmHg=0.133 kPa\uff09\u548c\uff08\u6216\uff09\u7ec4\u7ec7\u704c\u6ce8\u4e0d\u8db3\u3001\u4ee3\u8c22\u6027\u78b1\u4e2d\u6bd2\u3001\u9ad8\u9499\u8840\u75c7\u53ca\u9ad8\u94a0\u8840\u75c7\u7684\u60a3\u8005\u5e94\u614e\u7528\u67b8\u6a7c\u9178\u94a0\u3002<\/p>\n

\u963f\u52a0\u66f2\u73ed\u5728\u809d\u810f\u4ee3\u8c22\uff0c\u4ee3\u8c22\u4ea7\u7269\u7531\u80c6\u7ba1\u7cfb\u7edf\u6392\u6cc4\uff0c\u809d\u529f\u80fd\u4e0d\u5168\u60a3\u8005\u963f\u52a0\u66f2\u73ed\u7684\u6e05\u9664\u53ef\u51cf\u5c1175%\uff0c\u534a\u8870\u671f\u5ef6\u957f2~3\u500d\uff3b65\uff3d<\/sup>\u3002\u6587\u732e\u62a5\u9053\u8840\u6db2\u900f\u6790\u60a3\u8005\u5e94\u7528\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u53ef\u53d1\u751f\u8fc7\u654f\u53cd\u5e94\uff3b66, 67\uff3d<\/sup>\uff0c\u56e0\u6b64\u65e2\u5f80\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u8fc7\u654f\u60a3\u8005\u7981\u7528\u3002<\/p>\n

\u63a8\u8350\u610f\u89c129\uff1a\u5bf9\u65e0\u51fa\u8840\u98ce\u9669\u7684\u60a3\u8005\uff0c\u5efa\u8bae\u9009\u62e9\u666e\u901a\u809d\u7d20\u6216\u4f4e\u5206\u5b50\u809d\u7d20\u4f5c\u4e3aHDF\u7684\u6297\u51dd\u5242\u3002\uff08A1a\uff09<\/p>\n

\u57fa\u4e8e11\u9879\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u666e\u901a\u809d\u7d20\u6bd4\u8f83\uff0c\u4f4e\u5206\u5b50\u809d\u7d20\u7684\u4f53\u5916\u5faa\u73af\u8840\u6813\u5f62\u6210\uff08RR=1.15\uff0c95%CI\uff1a0.70~1.91\uff0cI2<\/sup>=57.3%\uff09\u3001\u51fa\u8840\u4e8b\u4ef6\uff08RR=0.96\uff0c95%CI\uff1a0.27~3.43\uff0cI2<\/sup>=62.8%\uff09\u4ee5\u53ca\u8840\u7ba1\u901a\u8def\u538b\u8feb\u65f6\u95f4\uff3b\u52a0\u6743\u5e73\u5747\u5dee\uff08WMD\uff09=-0.87\uff0c95%CI\uff1a-2.75~1.02\uff3d\u5747\u65e0\u660e\u663e\u5dee\u522b\uff3b68\uff3d<\/sup>\u3002<\/p>\n

\u63a8\u8350\u610f\u89c130\uff1a\u5bf9\u5408\u5e76\u51fa\u8840\u6027\u75be\u75c5\u6216\u9ad8\u5371\u51fa\u8840\u98ce\u9669\u7684\u60a3\u8005\uff0c\u9664\u5916\u836f\u7269\u7981\u5fcc\uff0con-line HDF\u6cbb\u7597\u65f6\u63a8\u8350\u9009\u62e9\u963f\u52a0\u66f2\u73ed\u6216\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u4f5c\u4e3aHDF\u7684\u6297\u51dd\u5242\uff1b\u975e\u8054\u673aHDF\u6cbb\u7597\u65f6\u4e5f\u53ef\u9009\u62e9\u5c40\u90e8\u67b8\u6a7c\u9178\u94a0\u6297\u51dd\u3002\uff08A1b\uff09<\/p>\n

\u63a5\u53d7\u95f4\u6b47\u6027\u9759\u8109-\u9759\u8109\u8840\u6db2\u6ee4\u8fc7\uff08IVVH\uff09\u7684\u4f34\u6709\u9ad8\u5371\u51fa\u8840\u98ce\u9669\u7684\u6025\u6027\u80be\u635f\u4f24\u60a3\u8005\u7684\u524d\u77bb\u6027\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u4e2d\uff0c\u4e0e\u65e0\u6297\u51dd\u5242\u6bd4\u8f83\uff0c\u963f\u52a0\u66f2\u73ed\u53ef\u6709\u6548\u63d0\u4f9b\u4f53\u5916\u5faa\u73af\u6297\u51dd\u4f5c\u7528\uff0c\u4e14\u4e0d\u5f71\u54cd\u60a3\u8005\u4f53\u5185\u51dd\u8840\u72b6\u6001\uff0c\u672a\u53d1\u73b0\u4e25\u91cd\u51fa\u8840\u548c\u4e25\u91cd\u4e0d\u826f\u53cd\u5e94\uff3b69\uff3d<\/sup>\u3002<\/p>\n

\u4e00\u7bc7\u9488\u5bf917\u9879\u89c2\u5bdf\u6027\u7814\u7a76\u548c3\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u65e0\u6297\u51dd\u5b9e\u65bdCRRT\u7ec4\u6bd4\u8f83\uff0c\u4f7f\u7528\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u5b9e\u65bdCRRT\u7ec4\u7684\u6ee4\u5668\u5bff\u547d\u663e\u8457\u5ef6\u957f\uff08WMD=-8.4\uff0c95%CI\uff1a-9.9~-6.9\uff0cI2<\/sup>=33.7%\uff09\uff3b70\uff3d<\/sup>\u300273\u4f8b\u5408\u5e76\u51fa\u8840\u503e\u5411\u3001\u5b9e\u65bdCRRT\u7684\u6025\u6027\u80be\u635f\u4f24\u60a3\u8005\u7684\u524d\u77bb\u6027\u968f\u673a\u5bf9\u7167\u7814\u7a76\u4e2d\uff0c\u4e0e\u65e0\u6297\u51dd\u836f\u7269\u6bd4\u8f83\uff0c\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u663e\u8457\u5ef6\u957f\u6ee4\u5668\u5bff\u547d\u3001\u51cf\u5c11\u4f7f\u7528\u6ee4\u5668\u6570\u91cf\uff0c\u800c\u8f93\u8840\u53ca\u60a3\u8005\u75c5\u6b7b\u7387\u6216\u751f\u5b58\u7387\u65e0\u660e\u663e\u5dee\u5f02\uff3b71\uff3d<\/sup>\u3002<\/p>\n

\u53e6\u4e00\u7bc7\u57fa\u4e8e14\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c1 134\u4f8b\u63a5\u53d7CRRT\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u809d\u7d20\u6cbb\u7597\u7ec4\u6bd4\u8f83\uff0c\u67b8\u6a7c\u9178\u94a0\u6cbb\u7597\u7ec4\u7684\u60a3\u8005\u75c5\u6b7b\u7387\u65e0\u660e\u663e\u5dee\u5f02\uff08RR=0.97\uff0c95%CI\uff1a0.84~1.13\uff09\uff1b\u4f46\u663e\u8457\u5ef6\u957f\u8fde\u7eed\u9759\u8109-\u9759\u8109\u8840\u6db2\u6ee4\u8fc7\uff08CVVH\uff09\u4e9a\u7ec4\uff08MD=8.18\uff0c95%CI\uff1a3.86~12.51\uff09\u548c\u7a00\u91ca\u524d\u4e9a\u7ec4\uff08MD=17.51\uff0c95%CI\uff1a9.85~25.17\uff09\u7684\u7ba1\u8def\u4f7f\u7528\u65f6\u95f4\uff0c\u663e\u8457\u964d\u4f4e\u51fa\u8840\u98ce\u9669\uff08RR=0.31\uff0c95%CI\uff1a0.19~0.51\uff09\uff0c\u663e\u8457\u51cf\u5c11HIT\u53d1\u751f\u98ce\u9669\uff08RR=0.41\uff0c95%CI\uff1a0.19~0.87\uff09\uff3b72\uff3d<\/sup>\u300217\u9879\u89c2\u5bdf\u6027\u7814\u7a76\u548c3\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u65e0\u6297\u51dd\u5b9e\u65bdCRRT\u7ec4\u6bd4\u8f83\uff0c\u4f7f\u7528\u5c40\u90e8\u67b8\u6a7c\u9178\u6297\u51dd\u5b9e\u65bdCRRT\u7ec4\u7684\u6ee4\u5668\u5bff\u547d\u663e\u8457\u5ef6\u957f\uff08WMD=-23.01\uff0c95%CI\uff1a-28.62~-17.39\uff0cI2<\/sup>=0\uff09\uff3b70\uff3d<\/sup>\u3002<\/p>\n

\u9700\u8981\u6ce8\u610f\u7684\u662f\uff0con-line HDF\u6cbb\u7597\u65f6\u7f6e\u6362\u6db2\u548c\u900f\u6790\u6db2\u4e2d\u5747\u542b\u6709\u9499\u79bb\u5b50\uff0c\u7531\u4e8e\u542b\u9499\u900f\u6790\u6db2\uff08\u524d\u7a00\u91caHDF\u6cbb\u7597\u8fd8\u5305\u62ec\u542b\u9499\u7f6e\u6362\u6db2\uff09\u4e0d\u65ad\u8fdb\u5165\u900f\u6790\u5668\/\u6ee4\u5668\uff0c\u5bfc\u81f4\u900f\u6790\u5668\/\u6ee4\u5668\u9759\u8109\u7aef\u5927\u90e8\u5206\u65e0\u6cd5\u5b9e\u73b0\u63a7\u5236\u6e38\u79bb\u9499\u79bb\u5b50\u6d53\u5ea60.25~0.35 mmol\/L\uff0c\u4e0d\u80fd\u5b9e\u73b0\u900f\u6790\u5668\/\u6ee4\u5668\u548c\u9759\u8109\u58f6\u7684\u6709\u6548\u6297\u51dd\uff0c\u589e\u52a0\u900f\u6790\u5668\/\u6ee4\u5668\u548c\u9759\u8109\u58f6\u51dd\u8840\u4e8b\u4ef6\u53d1\u751f\u98ce\u9669\uff1b\u82e5\u8fbe\u5230\u4f53\u5916\u5faa\u73af\u7684\u5145\u5206\u6297\u51dd\uff0c\u5fc5\u987b\u589e\u52a0\u67b8\u6a7c\u9178\u76d0\u7684\u8f93\u6ce8\u91cf\uff0c\u53ef\u5bfc\u81f4\u4ee3\u8c22\u6027\u78b1\u4e2d\u6bd2\u3001\u4f4e\u9499\u8840\u75c7\u548c\u9ad8\u94a0\u8840\u75c7\u53d1\u751f\u98ce\u9669\u589e\u52a0\uff0c\u4e14\u540c\u65f6\u7f6e\u6362\u6db2\u7684\u9499\u6d53\u5ea6\u4e0d\u80fd\u6709\u6548\u62ee\u6297\u8f93\u6ce8\u7684\u67b8\u6a7c\u9178\uff0c\u589e\u52a0\u51fa\u8840\u548c\u4f4e\u9499\u8840\u75c7\u98ce\u9669\uff1b\u540e\u7a00\u91caHDF\u6cbb\u7597\u65f6\u9759\u8109\u58f6\u8ffd\u52a0\u8865\u5145\u67b8\u6a7c\u9178\u76d0\u53ef\u51cf\u5c11\u9759\u8109\u58f6\u51dd\u8840\uff0c\u4f46\u589e\u52a0\u67b8\u6a7c\u9178\u76d0\u7684\u8f93\u6ce8\u91cf\uff0c\u5bfc\u81f4\u4f4e\u9499\u8840\u75c7\u3001\u4ee3\u8c22\u6027\u78b1\u4e2d\u6bd2\u548c\u9ad8\u94a0\u8840\u75c7\u53d1\u751f\u98ce\u9669\u8fdb\u4e00\u6b65\u589e\u52a0\u3002\u56e0\u6b64\uff0con-line HDF\u6cbb\u7597\u65f6\u4e0d\u5efa\u8bae\u4f7f\u7528\u5c40\u90e8\u67b8\u6a7c\u9178\u94a0\u6297\u51dd\u6cbb\u7597\uff1b\u5c40\u90e8\u67b8\u6a7c\u9178\u94a0\u6297\u51dd\u6cbb\u7597\u4ec5\u9002\u7528\u4e8e\u5408\u5e76\u51fa\u8840\u6216\u9ad8\u5371\u51fa\u8840\u98ce\u9669\u3001\u540c\u65f6\u5408\u5e76\u4e25\u91cd\u7535\u89e3\u8d28\u7d0a\u4e71\uff0c\u9700\u8981\u8c03\u6574\u7f6e\u6362\u6db2\u7535\u89e3\u8d28\u6d53\u5ea6\u800c\u8fdb\u884c\u975e\u8054\u673aHDF\u6cbb\u7597\u7684\u60a3\u8005\uff0c\u6b64\u65f6\u5e94\u91c7\u7528\u65e0\u9499\u7684\u5546\u54c1\u5316\u7f6e\u6362\u6db2\u3002<\/p>\n

\u63a8\u8350\u610f\u89c131\uff1a\u5bf9\u65e2\u5f80\u53d1\u751fHIT\u7684\u60a3\u8005\uff0c\u8fdb\u884cHDF\u6cbb\u7597\u65f6\u7981\u7528\u809d\u7d20\u7c7b\u836f\u7269\uff0c\u63a8\u8350\u9009\u62e9\u963f\u52a0\u66f2\u73ed\u4f5c\u4e3a\u6297\u51dd\u5242\uff0c\u6216\u9009\u62e9\u5176\u4ed6\u6297\u51dd\u836f\u3002\uff08A1a\uff09<\/p>\n

\u4e00\u987947\u4f8b\u524d\u77bb\u6027\u591a\u4e2d\u5fc3\u7814\u7a76\u4e2d\u63a5\u53d7\u4e86\u963f\u52a0\u66f2\u73ed\u6cbb\u7597\u4e14\u5408\u5e76\u80be\u529f\u80fd\u8870\u7aed\u9700\u8981\u80be\u810f\u66ff\u4ee3\u6cbb\u7597\u7684HIT\u60a3\u8005\u56de\u987e\u6027\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u963f\u52a0\u66f2\u73ed\u53ef\u63d0\u4f9b\u6709\u6548\u6297\u51dd\u4f5c\u7528\uff0c\u4e14\u51fa\u8840\u98ce\u9669\u8f83\u4f4e\uff3b73\uff3d<\/sup>\u30025\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c213\u4f8b\u80be\u810f\u66ff\u4ee3\u6cbb\u7597\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u963f\u52a0\u66f2\u73ed\u663e\u8457\u964d\u4f4eHIT\u60a3\u8005\u80be\u810f\u66ff\u4ee3\u6cbb\u7597\u4e2d\u65b0\u53d1\u8840\u6813\u7684\u53d1\u751f\u7387\uff08RR=0.40\uff0c95%CI\uff1a0.21~0.75\uff0cI2<\/sup>=0\uff09\uff3b74\uff3d<\/sup>\u3002<\/p>\n

\u4e09\u3001\u6297\u51dd\u5242\u7684\u5242\u91cf\u53ca\u5176\u8c03\u6574\u4e0e\u7ed9\u836f\u65b9\u5f0f<\/p>\n

\u63a8\u8350\u610f\u89c132\uff1a\u4ee5\u666e\u901a\u809d\u7d20\u4f5c\u4e3a\u6297\u51dd\u5242\u65f6\uff0c\u91c7\u7528\u521d\u59cb\u5242\u91cf\u540e\u6301\u7eed\u900f\u6790\u5668\/\u8840\u6ee4\u5668\u524d\u8ffd\u52a0\u7ed9\u836f\u65b9\u5f0f\uff0cHDF\u7ed3\u675f\u524d30 min\u505c\u6b62\u8ffd\u52a0\u3002\uff08D5\uff09<\/p>\n

\u666e\u901a\u809d\u7d20\u7684\u76f8\u5bf9\u5206\u5b50\u8d28\u91cf5 000~20 000 D\uff0c\u4e0e\u5206\u5b50\u91cf62 000 D\u7684\u6297\u51dd\u8840\u9176\u7ed3\u5408\u540e\u4e0d\u80fd\u88ab\u900f\u6790\u5668\/\u8840\u6ee4\u5668\u6e05\u9664\uff0c\u56e0\u6b64\u63a8\u8350\u7ed9\u4e88\u521d\u59cb\u5242\u91cf\u5145\u5206\u963b\u65ad\u8840\u6db2\u6d41\u7ecf\u900f\u6790\u7ba1\u8def\u548c\u8840\u6ee4\u5668\u8bf1\u53d1\u7684\u51dd\u8840\u6d3b\u5316\u57fa\u7840\u4e0a\uff0c\u901a\u8fc7\u900f\u6790\u5668\/\u8840\u6ee4\u5668\u7684\u8ffd\u52a0\u5242\u91cf\uff0c\u589e\u5f3a\u4f53\u5916\u5faa\u73af\u6297\u51dd\u4f5c\u7528\uff1b\u5c3f\u6bd2\u75c7\u60a3\u8005\u666e\u901a\u809d\u7d20\u534a\u8870\u671f\u4e3a30~60 min\uff0c\u4e3a\u5728\u900f\u6790\u7ed3\u675f\u540e\u6062\u590d\u60a3\u8005\u4f53\u5185\u51dd\u8840\u72b6\u6001\uff0c\u5efa\u8bae\u5728\u900f\u6790\u7ed3\u675f\u524d30~60 min\u505c\u6b62\u8ffd\u52a0\u5242\u91cf\uff3b60\uff3d<\/sup>\u3002<\/p>\n

\u63a8\u8350\u610f\u89c133\uff1a\u4ee5\u4f4e\u5206\u5b50\u809d\u7d20\u4f5c\u4e3a\u6297\u51dd\u5242\u65f6\uff0c\u5efa\u8baeHDF\u6cbb\u7597\u524d\u4ece\u9759\u8109\u7aef\u4e00\u6b21\u6027\u7ed9\u836f\u3002\uff08A1b\uff09<\/p>\n

\u4e00\u987916\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\uff08\u542b8\u4f8bHDF\u6cbb\u7597\u60a3\u8005\uff09\u53cc\u4e2d\u5fc3\u3001\u524d\u77bb\u6027\u3001\u5f00\u653e\u6807\u8bb0\u7684\u968f\u673a\u4ea4\u53c9\u8bd5\u9a8c\u7ed3\u679c\u663e\u793a\uff0c\u4f9d\u8bfa\u809d\u7d20\u4f5c\u4e3a\u6297\u51dd\u5242\u7684HDF\u6cbb\u7597\u60a3\u8005\uff0c4 h\u7684\u6297\u51dd\u8840\u56e0\u5b50\u2169a\u6d3b\u6027\uff0c\u9759\u8109\u7ed9\u836f\u663e\u8457\u9ad8\u4e8e\u7ba1\u8def\u52a8\u8109\u7aef\u7ed9\u836f\uff3b\uff080.82\u00b10.29\uff09U\/ml\u6bd4\uff080.39\u00b10.14\uff09U\/ml\uff0cP<0.001\uff3d\uff3b75\uff3d<\/sup>\u300213\u4f8b\u7ef4\u6301\u6027\u540e\u7a00\u91caHDF\u6cbb\u7597\u60a3\u8005\u7684\u524d\u77bb\u6027\u968f\u673a\u4ea4\u53c9\u8bd5\u9a8c\u7ed3\u679c\u8bc1\u5b9e\uff0cHDF\u524d\u52a8\u8109\u7aef\u6ce8\u5c04\u53ef\u5bfc\u81f4\u4ead\u624e\u809d\u7d20\u6297\u51dd\u6d3b\u6027\u7684\u4e27\u5931\uff3b76\uff3d<\/sup>\u300249\u4f8bon-line HDF\u6cbb\u7597\u60a3\u8005\u7684\u524d\u77bb\u6027\u5bf9\u7167\u8bd5\u9a8c\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u7ba1\u8def\u52a8\u8109\u7aef\u6ce8\u5c04\u90a3\u5c48\u809d\u7d20\u6bd4\u8f83\uff0c\u9759\u8109\u7aef\u7ed9\u836f\u663e\u8457\u589e\u52a0\u6d01\u51c0\u900f\u6790\u5668\u6bd4\u4f8b\uff0c\u663e\u8457\u51cf\u5c11\u900f\u6790\u5668\u51dd\u7ed3\u6bd4\u4f8b\uff1b\u90a3\u5c48\u809d\u7d20\u5e73\u5747\u4f7f\u7528\u5242\u91cf\uff0c\u7ba1\u8def\u52a8\u8109\u7aef\u6ce8\u5c04\u4e3a0.43 ml\uff0c\u7ba1\u8def\u9759\u8109\u7aef\u6ce8\u5c04\u4e3a0.3 ml\uff0c\u7ba1\u8def\u9759\u8109\u7aef\u6ce8\u5c04\u4e14\u51cf\u5c11\u5242\u91cf33%~50%\u540eKt\/V\u4ece1.64\u63d0\u9ad8\u81f31.75\uff0c\u7f6e\u6362\u6db2\u5242\u91cf\u4ece20.18 L\u589e\u52a0\u81f321.96 L\uff3b77\uff3d<\/sup>\u3002<\/p>\n

\u63a8\u8350\u610f\u89c134\uff1a\u5bf9\u4e8e\u4f34\u6709\u51fa\u8840\u98ce\u9669\u91c7\u7528\u963f\u52a0\u66f2\u73ed\u3001\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u6216\u5c40\u90e8\u67b8\u6a7c\u9178\u94a0\u8fdb\u884c\u6297\u51dd\u6cbb\u7597\u7684\u60a3\u8005\uff0c\u4f9d\u636eHDF\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u60a3\u8005\u4f53\u5185\u548c\u4f53\u5916\u5faa\u73af\u51dd\u8840\u72b6\u6001\u4ee5\u53ca\u6cbb\u7597\u7ed3\u675f\u540e\u4f53\u5185\u51dd\u8840\u72b6\u6001\u7684\u76d1\u6d4b\u7ed3\u679c\u4e2a\u4f53\u5316\u8c03\u6574\u6297\u51dd\u5242\u7684\u5242\u91cf\u3002\uff08D5\uff09<\/p>\n

\u91c7\u7528\u963f\u52a0\u66f2\u73ed\u6297\u51dd\u6cbb\u7597\u65f6\uff0c\u521d\u59cb\u5242\u91cf75 \u03bcg\/kg\uff0c\u8ffd\u52a0\u5242\u91cf0.4~0.6 \u03bcg\u00b7kg-1<\/sup>\u00b7min-1<\/sup>\u6301\u7eed\u900f\u6790\u5668\/\u8840\u6ee4\u5668\u8f93\u6ce8\uff1b\u6216\u80051~2 \u03bcg\u00b7kg-1<\/sup>\u00b7min-1<\/sup>\u6301\u7eed\u6ee4\u5668\u524d\u8f93\u6ce8\uff1b\u63a7\u5236\u6ee4\u5668\u540e\u7684APTT>\u57fa\u7840\u503c\u76843.0\u500d\uff0c\u60a3\u8005\u4f53\u5185APTT<\u57fa\u7840\u503c\u76841.5\u500d\uff1b\u76f4\u81f3HDF\u6cbb\u7597\u7ed3\u675f\u3002<\/p>\n

\u91c7\u7528\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u6297\u51dd\u6cbb\u7597\u65f6\uff0c\u7ed9\u4e8820~50 mg\/h\u6301\u7eed\u6ee4\u5668\u524d\u8f93\u6ce8\u3002\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u7684\u6709\u6548\u5242\u91cf\u548c\u76d1\u6d4b\u65b9\u6cd5\u5c1a\u672a\u5f62\u6210\u5171\u8bc6\uff0c\u4e00\u822c\u800c\u8a00\u5e94\u63a7\u5236\u60a3\u8005\u4f53\u5185APTT<\u57fa\u7840\u503c\u76841.5\u500d\uff0c\u4ee5\u907f\u514d\u53d1\u751f\u51fa\u8840\u4e8b\u4ef6\u3002\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u534a\u8870\u671f\u5f88\u77ed\uff0c\u5e94\u5728HDF\u6cbb\u7597\u7ed3\u675f\u65f6\u518d\u505c\u7528\u3002<\/p>\n

\u5bf9\u4e8e\u540c\u65f6\u5408\u5e76\u4e25\u91cd\u7535\u89e3\u8d28\u7d0a\u4e71\uff0c\u9700\u8981\u8c03\u6574\u7f6e\u6362\u6db2\u7535\u89e3\u8d28\u6d53\u5ea6\u800c\u8fdb\u884c\u975e\u8054\u673aHDF\u6cbb\u7597\u7684\u60a3\u8005\u91c7\u7528\u5c40\u90e8\u67b8\u6a7c\u9178\u94a0\u6297\u51dd\u6cbb\u7597\u65f6\uff0c\u63a8\u8350\u4f7f\u7528\u65e0\u9499\u7684\u5546\u54c1\u5316\u7f6e\u6362\u6db2\uff0c\u900f\u6790\u5668\/\u8840\u6ee4\u5668\u524d\u6301\u7eed\u8f93\u6ce8\u67b8\u6a7c\u9178\u94a0\uff0c\u63a7\u5236\u6ee4\u5668\u540e\u7684\u6e38\u79bb\u9499\u79bb\u5b50\u6d53\u5ea60.25~0.35 mmol\/L\uff0cPT>\u57fa\u7840\u503c\u76842.5\u500d\u3001INR>2.5\u6216APTT>\u57fa\u7840\u503c\u76843.0\u500d\uff1b\u5728\u9759\u8109\u7aef\u6301\u7eed\u8f93\u6ce8\u9499\u5236\u5242\uff0c\u63a7\u5236\u60a3\u8005\u4f53\u5185\u6e38\u79bb\u9499\u79bb\u5b50\u6d53\u5ea61.00~1.35 mmol\/L\uff0cPT\u3001INR\u6216APTT<\u57fa\u7840\u503c\u76841.5\u500d\uff1b\u76f4\u5230HDF\u6cbb\u7597\u7ed3\u675f\u3002\u4e0d\u5efa\u8baeon-line HDF\u6cbb\u7597\u65f6\u91c7\u7528\u5c40\u90e8\u67b8\u6a7c\u9178\u94a0\u6297\u51dd\u6cbb\u7597\u3002<\/p>\n

\u56db\u3001\u9632\u6cbb\u6297\u51dd\u6cbb\u7597\u7684\u4e0d\u826f\u4e8b\u4ef6<\/p>\n

\u63a8\u8350\u610f\u89c135\uff1a\u53d1\u751f\u6297\u51dd\u6cbb\u7597\u4e0d\u826f\u4e8b\u4ef6\u65f6\uff0c\u53ca\u65f6\u8bc4\u4f30\u60a3\u8005\u51fa\u51dd\u8840\u72b6\u6001\uff0c\u91cd\u65b0\u9009\u62e9\u6297\u51dd\u836f\u7269\u53ca\u5176\u5242\u91cf\uff1b\u5e76\u9488\u5bf9\u4e0d\u826f\u53cd\u5e94\u7ed9\u4e88\u5904\u7406\u3002\uff08D5\uff09<\/p>\n

\uff08\u4e00\uff09\u51fa\u8840\u4e0e\u8840\u6813\u6813\u585e\u6027\u75be\u75c5<\/p>\n

\u5bf9\u4e8e\u5408\u5e76\u51fa\u8840\u6216\u51fa\u8840\u9ad8\u5371\u98ce\u9669\u7684\u60a3\u8005\uff0c\u5e94\u5c3d\u53ef\u80fd\u9009\u62e9\u67b8\u6a7c\u9178\u94a0\uff08\u975e\u8054\u673aHDF\uff09\u3001\u963f\u52a0\u66f2\u73ed\u6216\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u4f5c\u4e3a\u6297\u51dd\u836f\u7269\uff0c\u800c\u975e\u8fdb\u884c\u65e0\u6297\u51dd\u836f\u7269\u6cbb\u7597\uff1b\u5e94\u6ce8\u91cdHDF\u6cbb\u7597\u524d\u51dd\u8840\u72b6\u6001\u7684\u8bc4\u4f30\uff0c\u52a0\u5f3a\u8840\u6db2\u51c0\u5316\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u4f53\u5185\u51dd\u8840\u72b6\u6001\u7684\u76d1\u6d4b\uff0c\u4e2a\u4f53\u5316\u6297\u51dd\u6cbb\u7597\u3002\u666e\u901a\u809d\u7d20\u6216\u4f4e\u5206\u5b50\u809d\u7d20\u8fc7\u91cf\u53ef\u7ed9\u4e88\u9002\u91cf\u7684\u9c7c\u7cbe\u86cb\u767d\uff0c\u67b8\u6a7c\u9178\u94a0\u8fc7\u91cf\u53ef\u8865\u5145\u9499\u5236\u5242\uff0c\u963f\u52a0\u66f2\u73ed\u6216\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\u8fc7\u91cf\u53ef\u77ed\u6682\u89c2\u5bdf\uff0c\u4e25\u91cd\u8005\u53ef\u7ed9\u4e88\u51dd\u8840\u9176\u539f\u5236\u5242\u6216\u8840\u6d46\uff1b\u53d1\u751f\u8840\u6813\u6813\u585e\u6027\u75be\u75c5\u65f6\u5e94\u7ed9\u4e88\u6297\u51dd\u3001\u4fc3\u7ea4\u6eb6\u836f\u7269\u6cbb\u7597\uff3b78\uff3d<\/sup>\u3002<\/p>\n

\uff08\u4e8c\uff09\u6297\u51dd\u836f\u7269\u7684\u4e0d\u826f\u4e8b\u4ef6<\/p>\n

1. \u666e\u901a\u809d\u7d20\u6216\u4f4e\u5206\u5b50\u809d\u7d20\uff1a\u53d1\u751f\u8fc7\u654f\u6216HIT\u5e94\u7981\u7528\u809d\u7d20\u7c7b\u836f\u7269\uff1b\u53d1\u751fHIT\u540e\u5e94\u7ed9\u4e88\u963f\u52a0\u66f2\u73ed\u6297\u51dd\u548c\uff08\u6216\uff09\u4fc3\u7ea4\u6eb6\u836f\u7269\u6cbb\u7597\u3002<\/p>\n

2. \u67b8\u6a7c\u9178\u94a0\uff1a\u4ee3\u8c22\u6027\u78b1\u4e2d\u6bd2\u3001\u9ad8\u9499\u8840\u75c7\u3001\u4f4e\u9499\u8840\u75c7\u53ca\u9ad8\u94a0\u8840\u75c7\u7b49\uff0c\u53d1\u751f\u540e\u5e94\u9002\u5f53\u51cf\u5c11\u5176\u540eHDF\u6cbb\u7597\u65f6\u7684\u67b8\u6a7c\u9178\u94a0\u5242\u91cf\uff0c\u4e25\u91cd\u65f6\u5e94\u505c\u7528\u67b8\u6a7c\u9178\u94a0\uff0c\u6539\u7528\u963f\u52a0\u66f2\u73ed\u6216\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\uff0c\u4e0d\u5177\u5907\u6761\u4ef6\u65f6\u53ef\u91c7\u7528\u65e0\u6297\u51dd\u5242\u8fdb\u884cHDF\u6cbb\u7597\u3002<\/p>\n

3. \u963f\u52a0\u66f2\u73ed\uff1a\u8fc7\u654f\u3001\u4f4e\u8840\u538b\u3001\u53d1\u70ed\u3001\u6076\u5fc3\u3001\u8179\u6cfb\u3001\u623f\u5ba4\u4f20\u5bfc\u963b\u6ede\u3001\u5ba4\u6027\u5fc3\u52a8\u8fc7\u901f\u7b49\uff1b\u53d1\u751f\u8fc7\u654f\u548c\uff08\u6216\uff09\u4e25\u91cd\u4f4e\u8840\u538b\u7684\u60a3\u8005\u5176\u540eHDF\u6cbb\u7597\u65f6\u5e94\u7981\u7528\u963f\u52a0\u66f2\u73ed\uff1b\u53d1\u751f\u5176\u4ed6\u4e0d\u826f\u4e8b\u4ef6\u7684\u60a3\u8005\u7ed9\u4e88\u5bf9\u75c7\u6cbb\u7597\uff0c\u4e25\u91cd\u65f6\u5e94\u505c\u7528\u963f\u52a0\u66f2\u73ed\uff0c\u6539\u7528\u67b8\u6a7c\u9178\u94a0\u6216\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\uff0c\u4e0d\u5177\u5907\u6761\u4ef6\u65f6\u53ef\u91c7\u7528\u65e0\u6297\u51dd\u5242\u8fdb\u884cHDF\u6cbb\u7597\u3002<\/p>\n

4. \u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\uff1a\u9ad8\u8840\u94be\u3001\u4f4e\u8840\u94a0\u3001\u8fc7\u654f\u3001\u7c92\u7ec6\u80de\u51cf\u5c11\u3001\u8840\u5c0f\u677f\u5f02\u5e38\u3001\u809d\u529f\u80fd\u5f02\u5e38\u3001\u8179\u6cfb\u3001\u6076\u5fc3\u3001\u5455\u5410\u7b49\uff1b\u53d1\u751f\u8fc7\u654f\u7684\u60a3\u8005\u5176\u540eHDF\u6cbb\u7597\u65f6\u5e94\u7981\u7528\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\uff1b\u53d1\u751f\u9ad8\u8840\u94be\u6216\u4f4e\u8840\u94a0\u7684\u60a3\u8005\u5176\u540eHDF\u6cbb\u7597\u65f6\u5e94\u8c03\u6574\u900f\u6790\u6db2\u548c\uff08\u6216\uff09\u7f6e\u6362\u6db2\u7684\u94be\u79bb\u5b50\u4e0e\u94a0\u79bb\u5b50\u6d53\u5ea6\uff1b\u53d1\u751f\u5176\u4ed6\u4e0d\u826f\u4e8b\u4ef6\u7684\u60a3\u8005\u7ed9\u4e88\u5bf9\u75c7\u6cbb\u7597\uff0c\u4e25\u91cd\u65f6\u5e94\u505c\u7528\u7532\u78fa\u9178\u8418\u83ab\u53f8\u4ed6\uff0c\u6539\u7528\u67b8\u6a7c\u9178\u94a0\u6216\u963f\u52a0\u66f2\u73ed\uff0c\u4e0d\u5177\u5907\u6761\u4ef6\u65f6\u53ef\u91c7\u7528\u65e0\u6297\u51dd\u5242\u8fdb\u884cHDF\u6cbb\u7597\u3002<\/p>\n

\u4e94\u3001\u6297\u51dd\u6cbb\u7597\u7684\u533b\u7597\u8d28\u91cf\u63a7\u5236\u6307\u6807<\/p>\n

\u63a8\u8350\u610f\u89c136\uff1aHDF\u6297\u51dd\u6cbb\u7597\u6309\u4ee5\u4e0b\u6307\u6807\u8fdb\u884c\u8d28\u91cf\u63a7\u5236\u3002\u5efa\u8bae\u6309\u7167\u8d28\u63a7\u6307\u6807\u7ba1\u7406\u4e0e\u63a7\u5236HDF\u6297\u51dd\u6cbb\u7597\u7684\u533b\u7597\u8d28\u91cf\u3002\uff08D5\uff09<\/p>\n

1. HDF\u6cbb\u7597\u524d\u51dd\u8840\u6307\u6807\u68c0\u6d4b\u5b8c\u6210\u7387\uff1aHDF\u6cbb\u7597\u524d\u5b8c\u6210\u7cfb\u7edf\u51dd\u8840\u6307\u6807\u68c0\u6d4b\u7684\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002\u7cfb\u7edf\u51dd\u8840\u6307\u6807\uff1a\u81f3\u5c11\u5305\u62ec\u5168\u8840\u8840\u5c0f\u677f\u8ba1\u6570\u3001APTT\u6216ACT\u3001PT\u6216INR\u3001\u7ea4\u7ef4\u86cb\u767d\u539f\u5b9a\u91cf\u4ee5\u53caD-\u4e8c\u805a\u4f53\uff0c\u6709\u6761\u4ef6\u7684\u5355\u4f4d\u5e94\u68c0\u6d4b\u6297\u51dd\u8840\u9176\u6d3b\u6027\u3002<\/p>\n

2. HDF\u6cbb\u7597\u671f\u95f4\u5b9a\u671f\u51dd\u8840\u72b6\u6001\u8bc4\u4f30\u5b8c\u6210\u7387\uff1aHDF\u6cbb\u7597\u671f\u95f4\u81f3\u5c113\u4e2a\u6708\u5b8c\u62101\u6b21\u7cfb\u7edf\u51dd\u8840\u6307\u6807\u68c0\u6d4b\u7684\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002\u7cfb\u7edf\u51dd\u8840\u6307\u6807\uff1a\u81f3\u5c11\u5305\u62ec\u5168\u8840\u8840\u5c0f\u677f\u8ba1\u6570\u3001APTT\u6216ACT\u3001PT\u6216INR\u3001\u7ea4\u7ef4\u86cb\u767d\u539f\u5b9a\u91cf\u4ee5\u53caD-\u4e8c\u805a\u4f53\uff0c\u6709\u6761\u4ef6\u7684\u5355\u4f4d\u5e94\u68c0\u6d4b\u6297\u51dd\u8840\u9176\u6d3b\u6027\u3002<\/p>\n

3. HDF\u6cbb\u7597\u7ed3\u675f\u540e\u4e25\u91cd\u900f\u6790\u5668\/\u8840\u6ee4\u5668\u51dd\u8840\u53d1\u751f\u7387\uff1aHDF\u6cbb\u7597\u7ed3\u675f\u540e\u900f\u6790\u5668\/\u8840\u6ee4\u5668\u7684\u51dd\u8840\u7ea4\u7ef4\u4e1d>30%\u7684\u4f8b\u6b21\u5360\u5168\u90e8HDF\u6cbb\u7597\u4f8b\u6b21\u7684\u6bd4\u4f8b\u3002<\/p>\n

4. \u51fa\u8840\u6216\u8840\u6813\u6813\u585e\u75be\u75c5\u53d1\u751f\u7387\uff1a\u5355\u4f4d\u65f6\u95f4\u5185\uff0c\u53d1\u751f\u51fa\u8840\u6216\u8840\u6813\u6813\u585e\u75be\u75c5\u7684\u60a3\u8005\u5360\u5168\u90e8HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

\u7b2c\u4e03\u90e8\u5206 \u5904\u65b9\u8bbe\u7f6e<\/p>\n

\u4e00\u3001HDF\u7684\u5904\u65b9\u8bbe\u7f6e<\/p>\n

HDF\u7684\u5904\u65b9\u8bbe\u7f6e\u5305\u62ec\u900f\u6790\u5668\/\u8840\u6ee4\u5668\u3001\u6cbb\u7597\u6a21\u5f0f\u3001\u8d85\u6ee4\u91cf\u3001\u900f\u6790\u9891\u7387\u3001\u900f\u6790\u6db2\u7b49\u5185\u5bb9\u3002HDF\u5728\u900f\u6790\u5668\u3001\u8840\u6d41\u91cf\u548c\u900f\u6790\u6db2\u6d41\u901f\u3001\u6297\u51dd\u5242\u4f7f\u7528\u7b49\u65b9\u9762\u4e0d\u540c\u4e8e\u8840\u6db2\u900f\u6790\uff3b1\uff3d<\/sup>\u3002\u4e34\u5e8a\u4e0a\u5e94\u7efc\u5408\u8003\u8651\u60a3\u8005\u5177\u4f53\u60c5\u51b5\u65bd\u884c\u4e2a\u6027\u5316\u7684\u6cbb\u7597\u3002<\/p>\n

\u63a8\u8350\u610f\u89c137\uff1a\u9996\u9009\u8840\u6ee4\u5668\uff0c\u4e5f\u53ef\u4f7f\u7528\u5177\u6709\u9ad8\u6c34\u5206\u901a\u900f\u6027\u548c\u9ad8\u6eb6\u8d28\u6e17\u900f\u6027\u7684\u9ad8\u901a\u91cf\u900f\u6790\u5668\u8fdb\u884cHDF\u6cbb\u7597\uff0c\u5e94\u6ee1\u8db3\u8d85\u6ee4\u7cfb\u6570>20 ml\u00b7h-1<\/sup>\u00b7mmHg-1<\/sup>\u00b7m-2<\/sup>\uff0c\u03b22-\u5fae\u7403\u86cb\u767d\u7b5b\u9009\u7cfb\u6570>0.6\u3002\uff08A1b\uff09<\/p>\n

30\u4f8b\u6210\u5e74\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u5355\u4e2d\u5fc3\u3001\u524d\u77bb\u6027\u3001\u5f00\u653e\u3001\u968f\u673a\u4ea4\u53c9\u5bf9\u7167\u8bd5\u9a8c\u7ed3\u679c\u663e\u793a\uff0c\u5728\u5176\u4ed6\u900f\u6790\u53c2\u6570\u4fdd\u6301\u4e0d\u53d8\u7684\u6761\u4ef6\u4e0b\uff0c\u8840\u6ee4\u5668\u8f83\u9ad8\u901a\u91cf\u900f\u6790\u5668\u6e05\u9664\u03b22-\u5fae\u7403\u86cb\u767d\u3001\u808c\u7ea2\u86cb\u767d\u3001\u50ac\u4e73\u7d20\u548c\u767d\u86cb\u767d\u7684\u6548\u679c\u663e\u8457\u589e\u52a0\uff0c\u63d0\u793a\u8840\u6ee4\u5668\u8f83\u9ad8\u901a\u91cf\u900f\u6790\u5668\u80fd\u591f\u589e\u52a0\u4e2d\u5206\u5b50\u7269\u8d28\u7684\u6e05\u9664\uff3b79\uff3d<\/sup>\u3002\u6b27\u6d32\u900f\u6790\u5de5\u4f5c\u7ec4\uff08EUDIAL group\uff09\u5b9a\u4e49HDF\u900f\u6790\u5668\/\u6ee4\u5668\u6807\u51c6\u4e3a\u8d85\u6ee4\u7cfb\u6570>20 ml\u00b7h-1<\/sup>\u00b7mmHg-1<\/sup>\u00b7m-2<\/sup>\uff0c\u03b22-\u5fae\u7403\u86cb\u767d\u7b5b\u9009\u7cfb\u6570>0.6\uff3b80\uff3d<\/sup>\u3002\u4f46\u56e0\u4e3a\u9ad8\u901a\u900f\u6027\u819c\u900f\u6790\u5668\u5728\u6709\u6548\u6e05\u9664\u4e2d\u5206\u5b50\u6bd2\u7d20\u7684\u540c\u65f6\u4e5f\u53ef\u80fd\u4f1a\u5bfc\u81f4\u767d\u86cb\u767d\u7b49\u751f\u7406\u5fc5\u9700\u7269\u8d28\u7684\u4e22\u5931\uff0c\u9ad8\u901a\u91cf\u900f\u6790\u5668\u7684\u9009\u62e9\u8fd8\u9700\u6839\u636e\u60a3\u8005\u60c5\u51b5\u4e2a\u4f53\u5316\u9009\u62e9\uff0c\u5e76\u6839\u636e\u4f53\u8868\u9762\u79ef\u9009\u62e9\u8840\u6ee4\u5668\u7684\u819c\u9762\u79ef\uff0c\u901a\u5e38\u4e3a1.6~2.2 m2<\/sup>\u3002<\/p>\n

\u6b64\u5916\uff0c\u539f\u5219\u4e0a\u540e\u7a00\u91caHDF\u6cbb\u7597\u65f6\uff0c\u7531\u4e8e\u4ea7\u751f\u8840\u6ee4\u5668\/\u900f\u6790\u5668\u5185\u7684\u8840\u6db2\u6d53\u7f29\uff0c\u5bb9\u6613\u5347\u9ad8TMP\uff0c\u5177\u6709\u53d1\u751f\u7834\u819c\u98ce\u9669\uff1b\u5e94\u9009\u62e9\u80fd\u627f\u53d7\u66f4\u5927TMP\uff0c\u76f8\u5bf9\u8f83\u77ed\u4e14\u819c\u9762\u79ef\u8f83\u5927\u7684\u8840\u6ee4\u5668\/\u900f\u6790\u5668\u3002\u524d\u7a00\u91caHDF\u6cbb\u7597\u65f6\uff0c\u5e94\u9009\u62e9\u957f\u5ea6\u8f83\u957f\u7684\u8840\u6ee4\u5668\/\u900f\u6790\u5668\uff0c\u4ee5\u8fbe\u5230\u66f4\u597d\u7684\u6eb6\u8d28\u6e05\u9664\u6548\u679c\u3002<\/p>\n

\u4e34\u5e8a\u533b\u5e08\u8981\u5145\u5206\u4e86\u89e3\u8840\u6ee4\u5668\/\u900f\u6790\u5668\u7684\u7279\u6027\uff0c\u5305\u62ec\u819c\u6210\u5206\u3001\u6d88\u6bd2\u65b9\u5f0f\u3001\u819c\u9762\u79ef\u3001\u901a\u91cf\u3001\u6eb6\u8d28\u603b\u8f6c\u8fd0\u7cfb\u6570\uff08KoA\uff09\u3001\u8d85\u6ee4\u7cfb\u6570\uff08Kuf\uff09\u53ca\u751f\u7269\u4e0d\u76f8\u5bb9\u6027\u7b49\uff3b81\uff3d<\/sup>\uff0c\u5e76\u6839\u636e\u6cbb\u7597\u76ee\u7684\u3001\u6cbb\u7597\u6a21\u5f0f\u53ca\u60a3\u8005\u4f53\u8868\u9762\u79ef\u3001\u8840\u6d41\u901f\u5ea6\u7b49\u8fdb\u884c\u5408\u7406\u9009\u62e9\u3002<\/p>\n

\u63a8\u8350\u610f\u89c138\uff1a\u5efa\u8bae\u6bcf\u6b21\u900f\u6790\u51c0\u8d85\u6ee4\u603b\u91cf\u4e0d\u8d85\u8fc7\u5e72\u4f53\u91cd\u76845%\uff08D5\uff09\u3002\u63a8\u8350\u6bcf\u6b21HDF\u6cbb\u7597\u524d\u7a00\u91ca\u7f6e\u6362\u6db2\u91cf\u4e3a30~50 L\uff08B2b\uff09\uff0c\u540e\u7a00\u91ca\u7f6e\u6362\u6db2\u91cf\u4e3a18~25 L\uff08A1a\uff09\u3002<\/p>\n

\u6bcf\u6b21\u900f\u6790\u524d\u6839\u636e\u60a3\u8005\u65e2\u5f80\u900f\u6790\u8fc7\u7a0b\u4e2d\u8840\u538b\u548c\u900f\u6790\u524d\u8840\u538b\u60c5\u51b5\u3001\u673a\u4f53\u5bb9\u91cf\u72b6\u51b5\u4ee5\u53ca\u900f\u524d\u5b9e\u9645\u4f53\u91cd\uff0c\u8ba1\u7b97\u9700\u8981\u7684\u51c0\u8d85\u6ee4\u91cf\u3002\u5efa\u8bae\u6bcf\u6b21\u900f\u6790\u51c0\u8d85\u6ee4\u603b\u91cf\u4e0d\u8d85\u8fc7\u5e72\u4f53\u91cd\u76845%\u3002\u5b58\u5728\u4e25\u91cd\u6c34\u80bf\u3001\u6025\u6027\u80ba\u6c34\u80bf\u7b49\u60c5\u51b5\u65f6\uff0c\u8d85\u6ee4\u901f\u5ea6\u548c\u603b\u91cf\u53ef\u9002\u5f53\u63d0\u9ad8\u3002\u6839\u636e\u603b\u8d85\u6ee4\u91cf\u53ca\u9884\u8ba1\u6cbb\u7597\u65f6\u95f4\uff0c\u8bbe\u5b9a\u8d85\u6ee4\u901f\u5ea6\u3002\u540c\u65f6\u5728\u6cbb\u7597\u4e2d\u5e94\u5bc6\u5207\u76d1\u6d4b\u8840\u538b\u53d8\u5316\uff0c\u907f\u514d\u900f\u6790\u4e2d\u4f4e\u8840\u538b\u7b49\u5e76\u53d1\u75c7\u53d1\u751f\u3002<\/p>\n

4\u9879\u591a\u4e2d\u5fc3\u3001\u524d\u77bb\u6027\u968f\u673a\u5bf9\u7167\u7814\u7a76\uff08CONTRAST\u3001TURKISH\u3001ESHOL\u548cFrench\u7814\u7a76\uff092 793\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u4e2a\u4f53\u6c47\u603b\u6570\u636e\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u6bcf\u54683\u6b21\u3001\u6bcf\u6b21\u7f6e\u6362\u91cf>17.4~23 L\u540e\u7a00\u91caHDF\uff0c\u624d\u80fd\u8f83\u8840\u6db2\u900f\u6790\u663e\u8457\u964d\u4f4e\u5168\u56e0\u6b7b\u4ea1\u548c\u5fc3\u8840\u7ba1\u75c5\u6b7b\u4ea1\u98ce\u9669\uff3b15\uff3d<\/sup>\u30022 293\u4f8b\u63a5\u53d7\u540e\u7a00\u91ca\u7684on-line HDF\u6cbb\u7597\u3001\u968f\u8bbf\u81f3\u5c112\u5e74\u7684\u7ef4\u6301\u6027\u900f\u6790\u60a3\u8005\u961f\u5217\u7814\u7a76\u4e2d\uff0c\u6bcf\u5468\u7f6e\u6362\u6db2\u5242\u91cf>56.8 L\uff0832.7 L\/m2<\/sup>\uff09\u624d\u80fd\u663e\u8457\u589e\u52a0\u60a3\u8005\u751f\u5b58\u7387\uff3b7\uff3d<\/sup>\u3002\u57fa\u4e8e1998\u20142001\u5e74\u6b27\u6d32DOPPS\u7814\u7a76\u6570\u636e\u76842 165\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u56de\u987e\u6027\u961f\u5217\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u6bcf\u54683\u6b21\u3001\u6bcf\u6b21\u7f6e\u6362\u91cf15~25 L\u540e\u7a00\u91caHDF\u8f83\u4f4e\u901a\u91cf\u8840\u6db2\u900f\u6790\u663e\u8457\u964d\u4f4e\u5168\u56e0\u6b7b\u4ea1\u98ce\u9669\uff3b14\uff3d<\/sup>\u3002\u57fa\u4e8e\u65e5\u672c\u900f\u6790\u6cbb\u7597\u5b66\u4f1a\u80be\u810f\u6570\u636e\u6ce8\u518c\u6570\u636e\u5e93\u521b\u5efa\u76845 000\u5bf9\u60a3\u8005\u7684\u8840\u6db2\u900f\u6790\u6216\u524d\u7a00\u91caon-line HDF\u503e\u5411\u5339\u914d\u961f\u5217\uff0c\u8bc1\u5b9e\u7f6e\u6362\u91cf>40 L\/\u6b21\u7684\u524d\u7a00\u91caHDF\u60a3\u8005\u76841\u5e74\u5168\u56e0\u6b7b\u4ea1\u7387\u548c\u5fc3\u8840\u7ba1\u75c5\u6b7b\u4ea1\u7387\u5747\u663e\u8457\u4f4e\u4e8e\u8840\u6db2\u900f\u6790\u60a3\u8005\uff3b39\uff3d<\/sup>\u3002<\/p>\n

\u300a\u8840\u6db2\u51c0\u5316\u6807\u51c6\u64cd\u4f5c\u89c4\u7a0b\uff082021\u7248\uff09\u300b\uff3b42\uff3d<\/sup>\u4e2d\u63d0\u51fa\uff0c\u6839\u636e\u6ee4\u5668\u7684\u8d85\u6ee4\u7cfb\u6570\u53ca\u8840\u6d41\u901f\u5ea6\uff0c\u524d\u7a00\u91ca\u7f6e\u6362\u6db2\u91cf\u4e3a\u8840\u6d41\u91cf\u768450%~60%\uff0c\u5efa\u8bae\u524d\u7a00\u91caHDF\u7f6e\u6362\u91cf30~50 L\uff1b\u540e\u7a00\u91ca\u7f6e\u6362\u6db2\u91cf\u4e3a\u8840\u6d41\u91cf\u768425%~30%\uff0c\u5efa\u8bae\u540e\u7a00\u91caHDF\u7f6e\u6362\u91cf18~25 L\u3002<\/p>\n

\u63a8\u8350\u610f\u89c139\uff1a\u63a8\u8350\u81f3\u5c11\u6bcf\u54681\u6b21HDF\u6cbb\u7597\uff08B2b\uff09\uff0c\u6709\u6761\u4ef6\u5efa\u8bae\u6bcf\u54683\u6b21\uff08A1a\uff09\u3002<\/p>\n

\u591a\u9879\u5173\u4e8eHDF\u6cbb\u7597\u7684\u968f\u673a\u5bf9\u7167\u7814\u7a76\u662f\u57fa\u4e8e\u6bcf\u54683\u6b21\u7684\u6cbb\u7597\u6a21\u5f0f\u3002381\u4f8b65\u5c81\u4ee5\u4e0a\u8001\u5e74\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u524d\u77bb\u6027\u3001\u5f00\u653e\u6807\u7b7e\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff08French\u7814\u7a76\uff09\u7ed3\u679c\u663e\u793a\uff0c\u6bcf\u54683\u6b21HDF\u8f83\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u53ef\u4ee5\u51cf\u5c11\u4f4e\u8840\u538b\u53ca\u808c\u8089\u75c9\u631b\u98ce\u9669\uff3b6\uff3d<\/sup>\uff1b906\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684ESHOL\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u6bcf\u54683\u6b21HDF\u8f83\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u7684\u5168\u56e0\u6b7b\u4ea1\u7387\u51cf\u5c1130%\uff0c\u5fc3\u8840\u7ba1\u4e8b\u4ef6\u6b7b\u4ea1\u7387\u51cf\u5c1133%\uff0c\u611f\u67d3\u76f8\u5173\u6b7b\u4ea1\u7387\u51cf\u5c1155%\uff3b5\uff3d<\/sup>\u3002\u4e0a\u8ff04\u9879\u591a\u4e2d\u5fc3\u3001\u524d\u77bb\u6027\u968f\u673a\u5bf9\u7167\u7814\u7a76\u60a3\u8005\u7684\u4e2a\u4f53\u6c47\u603b\u6570\u636e\u5206\u6790\u4e5f\u8bc1\u5b9e\uff0c\u6bcf\u54683\u6b21\u6bcf\u6b21\u5145\u8db3\u7f6e\u6362\u91cf\u540e\u7a00\u91caHDF\u53ef\u8f83\u8840\u6db2\u900f\u6790\u663e\u8457\u964d\u4f4e\u5168\u56e0\u6b7b\u4ea1\u548c\u5fc3\u8840\u7ba1\u75c5\u6b7b\u4ea1\u98ce\u9669\uff3b15\uff3d<\/sup>\u3002\u76ee\u524d\u6b27\u6d32\u53ca\u65e5\u672c\u5df2\u5e7f\u6cdb\u5f00\u5c55\u6bcf\u54683\u6b21on-line HDF\u6cbb\u7597\u3002\u76ee\u524d\u6211\u56fd\u7531\u4e8e\u533b\u7597\u4fdd\u9669\u653f\u7b56\u3001\u900f\u6790\u673a\u53ca\u7ecf\u6d4e\u56e0\u7d20\u7b49\u9650\u5236\uff0c\u8f83\u96be\u5f00\u5c55\u6bcf\u54683\u6b21HDF\u6cbb\u7597\u3002\u6211\u56fd\u4e00\u9879\u591a\u4e2d\u5fc3\u56de\u987e\u6027\u961f\u5217\u7814\u7a76\u4e2d\uff0c\u6839\u636eHDF\u6cbb\u7597\u9891\u7387\u5206\u4e3a\u6bcf\u4e2a\u67081\u6b21HDF\u3001\u6bcf\u54681\u6b21HDF\u4ee5\u53ca\u5355\u7eaf\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\uff0c\u7ed3\u679c\u663e\u793a\u6bcf\u54681\u6b21HDF\u8f83\u5176\u4ed62\u7ec4\u5728\u75c5\u6b7b\u7387\u3001\u8425\u517b\u72b6\u51b5\u3001\u4f4f\u9662\u4e8b\u4ef6\u53ca\u4f4f\u9662\u4eba\u6b21\u7b49\u65b9\u9762\u5747\u6709\u6539\u5584\uff3b8\uff3d<\/sup>\u3002\u6211\u56fd\u53e6\u4e00\u9879\u7eb5\u5411\u961f\u5217\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u591a\u6570\u60a3\u8005\u6bcf\u5468\u63a5\u53d71\u6b21HDF\uff0c\u4e0e\u8840\u6db2\u900f\u6790\u7684\u6821\u6b63\u6b7b\u4ea1\u98ce\u9669\u6bd4\u4e3a0.85\uff0895%CI\uff1a0.71~1.03\uff09\uff0c\u63d0\u793aHDF\u5728\u4e2d\u56fd\u5177\u6709\u4e34\u5e8a\u76ca\u5904\uff3b82\uff3d<\/sup>\u3002\u56e0\u6b64\uff0c\u5efa\u8bae\u6839\u636e\u5b9e\u9645\u60c5\u51b5\u81f3\u5c11\u6bcf\u54682\u6b21\u8840\u6db2\u900f\u6790\u6cbb\u7597\u7ed3\u54081\u6b21HDF\u6cbb\u7597\u3002<\/p>\n

\u63a8\u8350\u610f\u89c140\uff1a\u5355\u6b21HDF\u6cbb\u7597\u65f6\u95f4\u22654 h\u3002\uff08A1b\uff09<\/p>\n

HDF\u6cbb\u7597\u65f6\u95f4\u901a\u5e38\u4e3a4 h\uff3b4\uff3d<\/sup>\u3002French\u7814\u7a76\u5e73\u5747HDF\u6cbb\u7597\u65f6\u95f4\u4e3a3.91~3.98 h\uff3b6\uff3d<\/sup>\uff1bESHOL\u7814\u7a76\u7684HDF\u65f6\u95f4\u4e3a234.3~236.6 min\uff3b5\uff3d<\/sup>\uff1bCONTRAST\u7814\u7a76\u7684HDF\u6cbb\u7597\u65f6\u95f4\u4e3a3.77~3.81 h\uff3b3\uff3d<\/sup>\u3002\u56e0\u6b64\u63a8\u8350\u5c06HDF\u5355\u6b21\u6cbb\u7597\u65f6\u95f4\u8bbe\u5b9a\u4e3a4 h\u3002<\/p>\n

\u63a8\u8350\u610f\u89c141\uff1a\u63a8\u8350\u9700\u7ed3\u5408\u60a3\u8005\u7684\u75c5\u60c5\u3001\u6280\u672f\u8bbe\u5907\u7684\u53ef\u53ca\u6027\u53ca\u533b\u7597\u4fdd\u9669\u653f\u7b56\u7b49\u591a\u79cd\u56e0\u7d20\u8fdb\u884c\u7efc\u5408\u8003\u8651\u9009\u62e9\u524d\u7a00\u91ca\u6216\u540e\u7a00\u91ca\u6a21\u5f0f\uff08D5\uff09\uff1b\u63a8\u8350\u6ee1\u8db3\u8840\u6d41\u91cf\u2265300 ml\/min\u7ed3\u5408\u7ea2\u7ec6\u80de\u6bd4\u5bb9\u226435%\u7684\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u9009\u62e9\u540e\u7a00\u91caHDF\u6cbb\u7597\u6a21\u5f0f\uff08A1a\uff09\uff1b\u5efa\u8bae\u8840\u6d41\u91cf\u2264250 ml\/min\u6216\u7ea2\u7ec6\u80de\u6bd4\u5bb9>35%\u7684\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u9009\u62e9\u524d\u7a00\u91caHDF\u6cbb\u7597\u6a21\u5f0f\uff08B2b\uff09\uff1b\u8840\u6d41\u91cf250~300 ml\/min\u60a3\u8005\u7ed3\u5408\u7ea2\u7ec6\u80de\u6bd4\u5bb9\uff0c\u9009\u62e9\u540e\u7a00\u91ca\u6216\u4f9d\u636e\u75c5\u60c5\u9700\u6c42\u9009\u62e9\u6cbb\u7597\u6a21\u5f0f\uff08D5\uff09\u3002<\/p>\n

\u5982\u524d\u6240\u8ff0\uff0c\u540e\u7a00\u91ca\u7f6e\u6362\u6db2\u91cf\u4e3a\u8840\u6d41\u91cf\u768425%~30%\uff0c\u5efa\u8bae\u540e\u7a00\u91caHDF\u7f6e\u6362\u91cf18~25 L\u3002\u540e\u7a00\u91caHDF\u6cbb\u7597\u65f6\u4e0d\u540c\u8840\u6d41\u91cf\u5bf9\u5e94\u7684\u8d85\u6ee4\u91cf\u89c1\u88683\u3002\u56e0\u6b64\uff0c\u4e3a\u8fbe\u5230\u6709\u6548\u7684\u7f6e\u6362\u5242\u91cf\uff0c\u91c7\u7528\u6ee4\u8fc7\u5206\u657025%\u9700\u8981\u8840\u6d41\u91cf\u2265300 ml\/min\uff0c\u91c7\u7528\u6ee4\u8fc7\u5206\u657030%\u9700\u8981\u8840\u6d41\u91cf\u2265250 ml\/min\u3002<\/p>\n

\u524d\u77bb\u6027\u3001\u5f00\u653e\u3001\u968f\u673a\u4ea4\u53c9\u5bf9\u7167\u8bd5\u9a8c\u7ed3\u679c\u663e\u793a\uff0c\u5c0f\u5206\u5b50\u6eb6\u8d28\u6e05\u9664\u7387\u53d7\u8840\u6d41\u91cf\u7684\u5f71\u54cd\u66f4\u660e\u663e\uff0c\u5f53\u8840\u6d41\u91cf\u589e\u52a0\u81f3500~600 ml\/min\u65f6\uff0c\u5c0f\u5206\u5b50\u6eb6\u8d28\u6e05\u9664\u7387\u4ecd\u9010\u6b65\u589e\u52a0\uff0c\u4f46\u4e2d\u5927\u5206\u5b50\u6eb6\u8d28\u7684\u6e05\u9664\u7387\u5728\u8840\u6d41\u91cf\u8d85\u8fc7250 ml\/min\u540e\u4e0d\u518d\u589e\u52a0\uff3b79\uff3d<\/sup>\u3002\u6b27\u76df\u836f\u54c1\u76d1\u7763\u7ba1\u7406\u5c40on-line HDF\u5171\u8bc6\u4f1a\u8bae\u62a5\u544a\u8ba4\u4e3a\uff0cHDF\u6700\u9002\u5408\u7684\u8840\u6d41\u901f\u5ea6\u4e3a350~450 ml\/min\uff3b80\uff3d<\/sup>\u3002ESHOL\u7814\u7a76\u4e2dHDF\u8840\u6d41\u91cf\u4e3a379~398 ml\/min\uff3b5\uff3d<\/sup>\uff0c\u800cCONTRAST\u7814\u7a76\u4e2dHDF\u4f7f\u7528\u7684\u8840\u6d41\u91cf\u4e3a312~352 ml\/min\uff3b3\uff3d<\/sup>\u3002<\/p>\n

\u63a8\u8350\u610f\u89c142\uff1aHDF\u5e38\u91c7\u7528\u900f\u6790\u6db2\u6d41\u901f\u4e3a500~800 ml\/min\uff08A1a\uff09\uff1b\u900f\u6790\u6db2\u6e29\u5ea6\u5e38\u8bbe\u5b9a\u4e3a36.5 \u2103\uff0c\u5bf9\u4e8e\u53cd\u590d\u53d1\u751f\u900f\u6790\u4e2d\u4f4e\u8840\u538b\u60a3\u8005\u53ef\u5c1d\u8bd5\u8fdb\u884c\u4f4e\u6e29\u900f\u6790\uff08A1a\uff09\uff0c\u5408\u5e76\u53d1\u70ed\u7684\u60a3\u8005\u53ef\u8fdb\u884c\u4f4e\u6e29\u900f\u6790\uff08A1b\uff09\u3002<\/p>\n

\u524d\u77bb\u6027\u3001\u5f00\u653e\u3001\u968f\u673a\u4ea4\u53c9\u5bf9\u7167\u8bd5\u9a8c\u7ed3\u679c\u663e\u793a\uff0c\u900f\u6790\u6db2\u6d41\u91cf\u4ece500 ml\/min\u589e\u52a0\u81f3800 ml\/min\uff0c\u5c0f\u5206\u5b50\u6eb6\u8d28\u7684\u6e05\u9664\u7387\u9010\u6b65\u589e\u52a0\uff0c\u4f46\u4e2d\u5927\u5206\u5b50\u6eb6\u8d28\u6e05\u9664\u7387\u65e0\u660e\u663e\u53d8\u5316\uff3b79\uff3d<\/sup>\u3002ESHOL\u7814\u7a76\u4e2dHDF\u900f\u6790\u6db2\u6d41\u901f\u4e3a541~590 ml\/min\uff3b5\uff3d<\/sup>\u30022 293\u4f8b\u81f3\u5c11\u968f\u8bbf2\u5e74\u7684on-line HDF\u60a3\u8005\u7684\u56de\u987e\u6027\u961f\u5217\u7814\u7a76\u4e2d\uff0cHDF\u900f\u6790\u6db2\u6d41\u901f\u4e3a\uff08506.1\u00b153.6\uff09ml\/min\uff3b7\uff3d<\/sup>\u3002<\/p>\n

26\u9879\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c484\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u6807\u51c6\u6e29\u5ea6\u900f\u6790\uff08\u900f\u6790\u6db2\u6e29\u5ea636~37.5 \u2103\uff09\u76f8\u6bd4\uff0c\u4f4e\u6e29\u900f\u6790\uff08\u900f\u6790\u6db2\u6e29\u5ea634.0~35.5 \u2103\uff09\u7684\u900f\u6790\u5185\u4f4e\u8840\u538b\u53d1\u751f\u7387\u964d\u4f4e\u4e8670%\uff0895%CI\uff1a49%~89%\uff09\uff0c\u900f\u6790\u6cbb\u7597\u65f6\u7684\u5e73\u5747\u52a8\u8109\u538b\u63d0\u9ad8\u4e8612 mmHg\uff0895%CI\uff1a8~16 mmHg\uff09\uff1b\u5bf9\u900f\u6790\u5145\u5206\u6027\u7684\u5f71\u54cd\u6ca1\u6709\u660e\u663e\u5dee\u5f02\uff3b83\uff3d<\/sup>\u3002\u4f46\u662f\uff0c97\u4e2a\u4e2d\u5fc315 413\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u5b9e\u7528\u3001\u53cc\u81c2\u3001\u5e73\u884c\u7ec4\u3001\u57fa\u4e8e\u6ce8\u518c\u3001\u5f00\u653e\u6807\u7b7e\u3001\u96c6\u7fa4\u968f\u673a\u3001\u4f18\u8d8a\u6027\u8bd5\u9a8c\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u6807\u51c6\u6e29\u5ea6\uff0836.4 \u2103\uff09\u7ec4\u6bd4\u8f83\uff0c\u4f4e\u6e29\u900f\u6790\u6db2\uff08\u5e73\u5747\u900f\u6790\u6db2\u6e29\u5ea635.8 \u2103\uff09\u7ec4\u7684\u5fc3\u8840\u7ba1\u76f8\u5173\u6b7b\u4ea1\u6216\u56e0\u5fc3\u808c\u6897\u6b7b\u3001\u7f3a\u8840\u6027\u5352\u4e2d\u6216\u5145\u8840\u6027\u5fc3\u529b\u8870\u7aed\u5165\u9662\u7684\u53d1\u751f\u7387\u65e0\u660e\u663e\u5dee\u522b\uff3b22.4%\u6bd421.4%\uff0c\u6821\u6b63\u76f8\u5bf9\u5371\u9669\u5ea6\uff08aRR\uff09=1.00\uff0c96%CI\uff1a0.89~1.10\uff3d\uff0c\u900f\u6790\u6cbb\u7597\u671f\u95f4\u5e73\u5747\u6536\u7f29\u538b\u4e0b\u964d\u503c\u65e0\u660e\u663e\u5dee\u522b\uff0827.1\u6bd426.6 mmHg\uff0cMD=-0.5 mmHg\uff0c99%CI\uff1a-1.4~0.4\uff09\uff3b84\uff3d<\/sup>\u3002\u56e0\u6b64\uff0c\u5bf9\u4e8e\u53cd\u590d\u53d1\u751f\u900f\u6790\u4e2d\u4f4e\u8840\u538b\u7684\u60a3\u8005\u53ef\u5c1d\u8bd5\u8fdb\u884c\u4f4e\u6e29\u900f\u6790\uff08\u900f\u6790\u6db2\u6e29\u5ea6<35.5 \u2103\uff09\u3002<\/p>\n

10\u4f8b\u8840\u6db2\u900f\u6790\u60a3\u8005\u968f\u673a\u4ea4\u53c9\u7814\u7a76\u7ed3\u679c\u663e\u793a\uff0c\u5e38\u89c4\u900f\u6790\u6db2\u6e29\u5ea6\uff0837 \u2103\uff09\u53ef\u589e\u52a0\u4eba\u4f53\u50a8\u70ed\u91cf\u5bfc\u81f4\u6838\u5fc3\u4f53\u6e29\u5347\u9ad80.4 \u2103\uff0c\u800c\u4f4e\u6e29\u900f\u6790\u6db2\uff0835 \u2103\uff09\u53ef\u963b\u6b62\u4eba\u4f53\u50a8\u70ed\u91cf\u548c\u6838\u5fc3\u6e29\u5ea6\u7684\u5347\u9ad8\uff3b85\uff3d<\/sup>\u3002\u56e0\u6b64\uff0c\u5bf9\u4e8e\u5408\u5e76\u53d1\u70ed\u7684\u60a3\u8005\u53ef\u8fdb\u884c\u4f4e\u6e29\u900f\u6790\u3002<\/p>\n

\u4e8c\u3001HDF\u5904\u65b9\u8bbe\u7f6e\u533b\u7597\u8d28\u91cf\u63a7\u5236\u6307\u6807<\/p>\n

\u63a8\u8350\u610f\u89c143\uff1a\u5efa\u8baeHDF\u5904\u65b9\u8bbe\u7f6e\u6309\u4ee5\u4e0b\u6307\u6807\u8fdb\u884c\u8d28\u91cf\u63a7\u5236\u3002\uff08D5\uff09<\/p>\n

1. HDF\u6709\u6548\u5242\u91cf\u8fbe\u6807\u7387\uff1aHDF\u6bcf\u6b21\u6cbb\u7597\u524d\u7a00\u91ca\u7f6e\u6362\u6db2\u91cf\u4e3a30~50 L\u6216\u540e\u7a00\u91ca\u7f6e\u6362\u6db2\u91cf\u4e3a18~25 L\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

2. \u6bcf\u54683\u6b21HDF\u6cbb\u7597\u7387\uff1a\u6bcf\u54683\u6b21HDF\u6cbb\u7597\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

3. \u900f\u6790\u95f4\u671f\u4f53\u91cd\u589e\u957f\u63a7\u5236\u7387\uff1a\u900f\u6790\u95f4\u671f\u4f53\u91cd\u589e\u957f<5%\u7684\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

\u7b2c\u516b\u90e8\u5206 \u76f8\u5173\u5e76\u53d1\u75c7\u9632\u6cbb<\/p>\n

\u4e00\u3001\u6025\u6027\u5e76\u53d1\u75c7\u53ca\u5176\u5904\u7406<\/p>\n

\uff08\u4e00\uff09\u611f\u67d3<\/p>\n

\u63a8\u8350\u610f\u89c144\uff1a\u4e0e\u8840\u6db2\u900f\u6790\u6bd4\u8f83\uff0cHDF\u4e0d\u589e\u52a0\u611f\u67d3\u98ce\u9669\uff08A1a\uff09\uff1b\u4f46\u63a8\u8350\u5728HDF\u6cbb\u7597\u65f6\u5fc5\u987b\u4f7f\u7528\u8d85\u7eaf\u900f\u6790\u6db2\uff0c\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u4e25\u683c\u65e0\u83cc\u64cd\u4f5c\uff0c\u4ee5\u51cf\u5c11\u611f\u67d3\u98ce\u9669\uff08D5\uff09\u3002<\/p>\n

714\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u591a\u4e2d\u5fc3\u3001\u524d\u77bb\u6027\u3001\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff08CONTRAST\u7814\u7a76\uff09\u4e2d\uff0c\u5e73\u57473.03\u5e74\u968f\u8bbf\u671f\u95f4\uff0c\u4f4e\u901a\u91cf\u8840\u6db2\u900f\u6790\u4e0eon-line HDF\u7ec4\u95f4\u611f\u67d3\u4e8b\u4ef6\u53d1\u751f\u7387\u65e0\u660e\u663e\u5dee\u5f02\uff3b3\uff3d<\/sup>\u3002782\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u591a\u4e2d\u5fc3\u3001\u524d\u77bb\u6027\u3001\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\uff08TURKISH\u7814\u7a76\uff09\u4e2d\uff0c\u5e73\u5747\u968f\u8bbf22.7\u4e2a\u6708\u671f\u95f4\uff0con-line HDF\u7ec4\u548c\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u7ec4\u95f4\u60a3\u8005\u611f\u67d3\u76f8\u5173\u6b7b\u4ea1\u7387\u65e0\u660e\u663e\u5dee\u522b\uff3b4\uff3d<\/sup>\u3002405\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u4e2d\uff0c3\u5e74\u968f\u8bbf\u7ed3\u679c\u663e\u793a\uff0c\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684C\u53cd\u5e94\u86cb\u767d\u548cIL-6\u6d53\u5ea6\u5347\u9ad8\uff0c\u800cHDF\u60a3\u8005\u4fdd\u6301\u7a33\u5b9a\uff1b\u8c03\u6574\u57fa\u7ebf\u53d8\u91cf\u540e2\u7ec4\u95f4\u7684\u53d8\u5316\u7387\u5b58\u5728\u663e\u8457\u5dee\u5f02\uff08C\u53cd\u5e94\u86cb\u767d\u5dee\u5f0220%\/\u5e74\uff0cIL-6\u5dee\u5f0216%\/\u5e74\uff09\uff0c\u63d0\u793a\u4e0e\u8840\u6db2\u900f\u6790\u76f8\u6bd4\uff0c\u4f7f\u7528\u8d85\u7eaf\u900f\u6790\u6db2\u7684\u957f\u671fHDF\u53ef\u968f\u65f6\u95f4\u63a8\u79fb\u964d\u4f4e\u708e\u75c7\u6c34\u5e73\uff3b27\uff3d<\/sup>\u3002906\u4f8b\u7ef4\u6301\u6027\u8840\u6db2\u900f\u6790\u60a3\u8005\u591a\u4e2d\u5fc3\u3001\u5f00\u653e\u6807\u7b7e\u3001\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7ed3\u679c\u663e\u793a\uff0c\u4e0e\u7ee7\u7eed\u8fdb\u884c\u8840\u6db2\u900f\u6790\u60a3\u8005\u6bd4\u8f83\uff0c\u63a5\u53d7on-line HDF\u60a3\u8005\u7684\u611f\u67d3\u76f8\u5173\u6b7b\u4ea1\u7387\u964d\u4f4e55%\uff08HR=0.45\uff0c95%CI\uff1a0.21~0.96\uff09\uff3b5\uff3d<\/sup>\u3002<\/p>\n

HDF\u60a3\u8005\u7684\u611f\u67d3\u4e3b\u8981\u539f\u56e0\u5305\u62ec\uff1a\u8840\u7ba1\u901a\u8def\u611f\u67d3\u3001\u4e0a\u4e0b\u673a\u65e0\u83cc\u64cd\u4f5c\u4ee5\u53ca\u7f6e\u6362\u6db2\u548c\u900f\u6790\u6db2\u7684\u751f\u7269\u6c61\u67d3\u7b49\u3002\u56e0\u6b64\uff0c\u5e94\u5efa\u8bae\u5b9a\u671f\u76d1\u6d4b\u900f\u6790\u6db2\u3001\u7f6e\u6362\u6db2\u7684\u7ec6\u83cc\u548c\u5185\u6bd2\u7d20\uff0c\u5b9a\u671f\u66f4\u6362\u5185\u6bd2\u7d20\u8fc7\u6ee4\u5668\uff1b\u76d1\u6d4b\u8840\u7ba1\u901a\u8def\u72b6\u6001\uff0cHDF\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u4e25\u683c\u65e0\u83cc\u64cd\u4f5c\uff0c\u4ee5\u51cf\u5c11\u611f\u67d3\u98ce\u9669\u3002<\/p>\n

\u63a8\u8350\u610f\u89c145\uff1a\u5bf9\u4e8eHDF\u6cbb\u7597\u4e2d\u6216\u6cbb\u7597\u540e\u51fa\u73b0\u53d1\u70ed\u7684\u60a3\u8005\uff0c\u5efa\u8bae\u540c\u65f6\u505a\u8840\u6db2\u3001\u8840\u7ba1\u901a\u8def\u3001\u7f6e\u6362\u6db2\u548c\u900f\u6790\u6db2\u7684\u7ec6\u83cc\u57f9\u517b\uff0c\u68c0\u6d4b\u7f6e\u6362\u6db2\u548c\u900f\u6790\u6db2\u5185\u6bd2\u7d20\uff1b\u5982\u786e\u8bca\u611f\u67d3\u5e94\u7ed9\u4e88\u6297\u611f\u67d3\u6cbb\u7597\u3002\uff08D5\uff09<\/p>\n

\u5bf9\u4e8e\u5728HDF\u6cbb\u7597\u4e2d\u548c\u6cbb\u7597\u540e\u51fa\u73b0\u53d1\u70ed\u4e14\u5176\u4ed6\u539f\u56e0\u4e0d\u80fd\u89e3\u91ca\u7684\u60a3\u8005\uff0c\u5e94\u540c\u65f6\u505a\u8840\u6db2\u3001\u8840\u7ba1\u901a\u8def\u3001\u7f6e\u6362\u6db2\u548c\u900f\u6790\u6db2\u7684\u7ec6\u83cc\u57f9\u517b\uff0c\u5e76\u68c0\u6d4b\u7f6e\u6362\u6db2\u548c\u900f\u6790\u6db2\u5185\u6bd2\u7d20\uff1b\u660e\u786e\u611f\u67d3\u75c5\u56e0\uff0c\u5e76\u7acb\u5373\u7ed9\u4e88\u6297\u611f\u67d3\u6cbb\u7597\u3002<\/p>\n

\uff08\u4e8c\uff09\u4f53\u5916\u5faa\u73af\u51dd\u8840<\/p>\n

\u5bfb\u627e\u4f53\u5916\u5faa\u73af\u53d1\u751f\u51dd\u8840\u7684\u539f\u56e0\u662f\u9884\u9632\u518d\u6b21\u53d1\u751f\u53ca\u8c03\u6574\u6297\u51dd\u5242\u7528\u91cf\u7684\u91cd\u8981\u4f9d\u636e\u3002HDF\u6cbb\u7597\u65f6\u53d1\u751f\u4f53\u5916\u5faa\u73af\u51dd\u8840\u7684\u5e38\u89c1\u539f\u56e0\u5305\u62ec\u4ee5\u4e0b\u51e0\u65b9\u9762\u3002<\/p>\n

1. \u540e\u7a00\u91caHDF\u8d85\u6ee4\u7387\u8fc7\u9ad8\uff1a\u5927\u90e8\u5206HDF\u6cbb\u7597\u91c7\u7528\u540e\u7a00\u91caHDF\u3002\u540e\u7a00\u91caHDF\u65f6\u5982\u679c\u8d85\u6ee4\u7387\u8fc7\u9ad8\u4f1a\u5bfc\u81f4\u8840\u6ee4\u5668\/\u900f\u6790\u5668\u7684\u8840\u6db2\u5ba4\u4e2d\u8840\u7ec6\u80de\u6bd4\u5bb9\u548c\u8840\u6e05\u86cb\u767d\u6d53\u5ea6\u663e\u8457\u589e\u52a0\uff0c\u5f15\u8d77\u8840\u6db2\u9ecf\u5ea6\u548c\u8de8\u819c\u538b\u5347\u9ad8\uff0c\u5bfc\u81f4\u86cb\u767d\u8d28\u6c89\u79ef\u5728\u819c\u8868\u9762\uff0c\u964d\u4f4e\u819c\u5bf9\u6db2\u4f53\u548c\u6eb6\u8d28\u7684\u901a\u900f\u6027\uff1b\u8fd9\u4e9b\u56e0\u7d20\u5c06\u8d85\u6ee4\u901f\u7387\u9650\u5236\u5728\u8840\u6db2\u6d41\u901f\u768430%\u5de6\u53f3\uff3b86\uff3d<\/sup>\u3002<\/p>\n

2. \u8840\u6d41\u901f\u5ea6\u8fc7\u6162\uff1a\u8840\u6d41\u901f\u5ea6\u8fc7\u6162\u6216\u8840\u6d41\u4e2d\u65ad\u65f6\u51dd\u8840\u7684\u53ef\u80fd\u6027\u589e\u52a0\u3002\u56e0\u6b64\uff0c\u4f7f\u7528HDF\u65f6\u9700\u5efa\u7acb\u53ef\u9760\u7684\u8840\u7ba1\u901a\u8def\uff0c\u4fdd\u8bc1\u8db3\u591f\u7684\u8840\u6d41\u91cf\u3002<\/p>\n

3. \u6297\u51dd\u5242\u7528\u91cf\u4e0d\u8db3\uff1aHDF\u9700\u8981\u7684\u6297\u51dd\u5242\u7528\u91cf\u5f80\u5f80\u9ad8\u4e8eHD\uff0c\u540e\u7a00\u91caon-line HDF\u60a3\u8005\u7684\u6297\u51dd\u836f\u5242\u91cf\uff08\u666e\u901a\u809d\u7d20\u6216\u4f4e\u5206\u5b50\u91cf\u809d\u7d20\uff09\u6bd4\u8840\u6db2\u900f\u6790\u60a3\u8005\u9ad810%~20%\uff3b87\uff3d<\/sup>\u300213\u4f8b\u7ef4\u6301\u6027HDF\u60a3\u8005\u968f\u673a\u4ea4\u53c9\u8bd5\u9a8c\u8bc1\u5b9e\uff0c\u6700\u6709\u6548\u7684\u4f4e\u5206\u5b50\u809d\u7d20\u4f7f\u7528\u65b9\u5f0f\u662f\u5728\u900f\u6790\u7ba1\u8def\u51fa\u53e3\u6ce8\u5c04\u4f4e\u5206\u5b50\u91cf\u809d\u7d20\uff3b76\uff3d<\/sup>\u3002<\/p>\n

4. \u5176\u4ed6\uff1a\u2460\u8840\u6db2\u9ecf\u6ede\u5ea6\u589e\u52a0\uff1a\u5b58\u5728\u8840\u7ea2\u86cb\u767d\u8fc7\u9ad8\u3001\u51b7\u7403\u86cb\u767d\u8840\u75c7\u3001\u5355\u514b\u9686\u4e19\u79cd\u7403\u86cb\u767d\u8840\u75c7\u7b49\u9ad8\u9ecf\u6ede\u72b6\u6001\uff1b\u2461\u900f\u6790\u4e2d\u8f93\u6ce8\u8840\u6db2\u3001\u8840\u5236\u54c1\u6216\u8102\u80aa\u4e73\u5242\uff1b\u2462\u900f\u6790\u8840\u7ba1\u901a\u8def\u518d\u5faa\u73af\u8fc7\u5927\uff1b\u2463\u5404\u79cd\u539f\u56e0\u5f15\u8d77\u52a8\u9759\u8109\u58f6\u6c14\u6ce1\u589e\u591a\u3001\u6db2\u9762\u8fc7\u9ad8\u3002<\/p>\n

\u63a8\u8350\u610f\u89c146\uff1aHDF\u6cbb\u7597\u65f6\u5e94\u907f\u514d\u540e\u7a00\u91ca\u8f93\u6ce8\u8d85\u6ee4\u7387\u8fc7\u9ad8\u3001\u8840\u6d41\u901f\u5ea6\u8fc7\u6162\uff0c\u5408\u7406\u9009\u62e9\u548c\u5e94\u7528\u6297\u51dd\u5242\u3002\uff08D5\uff09<\/p>\n

\u907f\u514d\u540e\u7a00\u91ca\u8f93\u6ce8\u8d85\u6ee4\u7387\u8fc7\u9ad8\u3001\u907f\u514d\u8840\u6db2\u901f\u5ea6\u8fc7\u6162\u3001\u53ca\u65f6\u8c03\u6574\u6297\u51dd\u5242\u5242\u91cf\u662f\u9884\u9632HDF\u6cbb\u7597\u65f6\u51dd\u8840\u7684\u5173\u952e\u3002\u5176\u4ed6\u9884\u9632\u65b9\u6cd5\u5305\u62ec\uff1a\u6cbb\u7597\u524d\u5168\u9762\u8bc4\u4f30\u60a3\u8005\u51dd\u8840\u72b6\u6001\uff0c\u9009\u62e9\u5408\u9002\u7684\u6297\u51dd\u5242\u53ca\u5176\u5242\u91cf\uff1b\u52a0\u5f3a\u900f\u6790\u4e2d\u51dd\u8840\u72b6\u51b5\u7684\u76d1\u6d4b\uff0c\u53ca\u65f6\u8c03\u6574\u6297\u51dd\u5242\u5242\u91cf\uff1b\u5c3d\u53ef\u80fd\u907f\u514d\u900f\u6790\u4e2d\u8f93\u6ce8\u8840\u6db2\u3001\u8840\u5236\u54c1\u548c\u8102\u80aa\u4e73\u7b49\u5f15\u8d77\u4f53\u5916\u5faa\u73af\u51dd\u8840\u7684\u5371\u9669\u56e0\u7d20\u3002<\/p>\n

\u63a8\u8350\u610f\u89c147\uff1a\u53d1\u751f\u8f7b\u5ea6\u51dd\u8840\u53ef\u4ee5\u8ffd\u52a0\u6297\u51dd\u5242\u7528\u91cf\uff0c\u8c03\u9ad8\u8840\u6d41\u901f\u5ea6\uff1b\u53d1\u751f\u91cd\u5ea6\u51dd\u8840\u9700\u7acb\u5373\u56de\u8840\uff0c\u66f4\u6362\u900f\u6790\u5668\/\u6ee4\u5668\u548c\u7ba1\u8def\u3002\uff08D5\uff09<\/p>\n

\u53d1\u751f\u8f7b\u5ea6\u51dd\u8840\u5e38\u53ef\u901a\u8fc7\u8ffd\u52a0\u6297\u51dd\u5242\u7528\u91cf\uff0c\u8c03\u9ad8\u8840\u6d41\u901f\u5ea6\u6765\u89e3\u51b3\u3002\u5728\u6cbb\u7597\u4e2d\u5e94\u4e25\u5bc6\u76d1\u6d4b\u60a3\u8005\u4f53\u5916\u5faa\u73af\u51dd\u8840\u60c5\u51b5\uff0c\u4e00\u65e6\u51dd\u8840\u7a0b\u5ea6\u52a0\u91cd\uff0c\u5e94\u7acb\u5373\u56de\u8840\uff0c\u66f4\u6362\u900f\u6790\u5668\/\u6ee4\u5668\u548c\u900f\u6790\u7ba1\u8def\u3002<\/p>\n

\u53d1\u751f\u91cd\u5ea6\u51dd\u8840\u5e38\u9700\u7acb\u5373\u56de\u8840\u3002\u5982\u56e0\u51dd\u8840\u7a0b\u5ea6\u91cd\u800c\u4e0d\u80fd\u56de\u8840\uff0c\u5219\u5efa\u8bae\u76f4\u63a5\u4e22\u5f03\u900f\u6790\u7ba1\u8def\u548c\u900f\u6790\u5668\/\u6ee4\u5668\uff0c\u4e0d\u4e3b\u5f20\u5f3a\u884c\u56de\u8840\uff0c\u4ee5\u514d\u51dd\u8840\u5757\u8fdb\u5165\u4f53\u5185\u53d1\u751f\u6813\u585e\u4e8b\u4ef6\u3002<\/p>\n

\uff08\u4e09\uff09\u808c\u8089\u75c9\u631b<\/p>\n

\u63a8\u8350\u610f\u89c148\uff1a\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u5e94\u7ea0\u6b63\u4f4e\u9499\u8840\u75c7\u7b49\u7535\u89e3\u8d28\u7d0a\u4e71\uff0c\u907f\u514dHDF\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u8d85\u6ee4\u7387\u8fc7\u5feb\uff0c\u9884\u9632\u4f4e\u8840\u538b\uff0c\u9632\u6cbb\u808c\u8089\u75c9\u631b\uff1b\u5bf9\u4e8e\u53cd\u590d\u53d1\u751f\u808c\u8089\u75c9\u631b\u7684\u60a3\u8005\uff0c\u5efa\u8bae\u4f7f\u75281.5 mmol\/L\u9499\u6d53\u5ea6\u6216\u77ed\u671f\u4f7f\u7528\u9ad8\u9499\uff081.75 mmol\/L\uff09\u900f\u6790\u6db2\u3002\uff08D5\uff09<\/p>\n

HDF\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u8840\u6e05\u79bb\u5b50\u9499\u4e0b\u964d\u5e45\u5ea6\u8f83\u5927\uff0c\u662f\u53d1\u751f\u808c\u8089\u75c9\u631b\u6700\u5e38\u89c1\u7684\u539f\u56e0\u3002HDF\u6cbb\u7597\u8fc7\u7a0b\u4e2d\uff0c\u7b2c1\u4e2a\u5c0f\u65f6\u79bb\u5b50\u9499\u4e0b\u964d\u5e45\u5ea6\u8f83\u5927\uff0c\u56e0\u6b64\u5bf9\u6f5c\u5728\u7684\u4f4e\u9499\u8840\u75c7\u7684\u8010\u53d7\u6027\u8f83\u5dee\uff3b88\uff3d<\/sup>\uff0c\u6545\u808c\u8089\u75c9\u631b\u591a\u89c1\u4e8e\u6bcf\u6b21\u6cbb\u7597\u7684\u4e2d\u540e\u671f\u3002\u5176\u4ed6\u5e38\u89c1\u539f\u56e0\u5305\u62ec\u4f4e\u94be\u8840\u75c7\u3001\u4f4e\u9541\u8840\u75c7\u3001\u900f\u6790\u4e2d\u4f4e\u8840\u538b\u3001\u4f4e\u8840\u5bb9\u91cf\u3001\u8d85\u6ee4\u901f\u5ea6\u8fc7\u5feb\u53ca\u5e94\u7528\u4f4e\u94a0\u900f\u6790\u6db2\u6cbb\u7597\u7b49\u3002<\/p>\n

\u56e0\u6b64\uff0c\u5bf9\u4e8e\u4f4e\u9499\u8840\u75c7\u60a3\u8005HDF\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u5e94\u907f\u514d\u8d77\u59cb\u8d85\u6ee4\u7387\u8fc7\u5feb\uff0c\u5efa\u8bae\u91c7\u75281.5 mmol\/L\u9499\u6d53\u5ea6\u6216\u77ed\u671f\u4f7f\u7528\u9ad8\u9499\uff081.75 mmol\/L\uff09\u900f\u6790\u6db2\uff1b\u5e76\u6ce8\u610f\u9632\u6cbb\u4f4e\u94be\u8840\u75c7\u3001\u4f4e\u94a0\u8840\u75c7\u3001\u4f4e\u9541\u8840\u75c7\uff0c\u6709\u6548\u63a7\u5236\u8d2b\u8840\u548c\u4f4e\u86cb\u767d\u8840\u75c7\uff1b\u8c03\u6574\u964d\u538b\u836f\u7269\u4f7f\u7528\uff0c\u9884\u9632\u900f\u6790\u76f8\u5173\u4f4e\u8840\u538b\u6216\u808c\u8089\u75c9\u631b\u7684\u53d1\u751f\u3002<\/p>\n

\uff08\u56db\uff09\u900f\u6790\u5668\u53cd\u5e94<\/p>\n

HDF\u6cbb\u7597\u65f6\u4f7f\u7528\u8840\u6ee4\u5668\u6216\u9ad8\u901a\u91cf\u900f\u6790\u5668\uff0c\u5176\u900f\u6790\u5668\u53cd\u5e94\u4e34\u5e8a\u5206\u4e3a\u4e24\u7c7b\uff1aA\u578b\u53cd\u5e94\uff08\u8fc7\u654f\u53cd\u5e94\u578b\uff09\u548c B\u578b\u53cd\u5e94\u3002\u6211\u56fd\u900f\u6790\u5668\u53cd\u5e94\u53d1\u751f\u7387\u7ea62.11%\uff3b89\uff3d<\/sup>\u3002<\/p>\n

1. A\u578b\u900f\u6790\u5668\u53cd\u5e94<\/p>\n

\u63a8\u8350\u610f\u89c149\uff1a\u53d1\u751fA\u578b\u900f\u6790\u5668\u53cd\u5e94\uff0c\u5e94\u7acb\u5373\u7d27\u6025\u5904\u7406\uff0c\u5e76\u5bfb\u627e\u539f\u56e0\uff0c\u91c7\u53d6\u9884\u9632\u63aa\u65bd\u907f\u514d\u518d\u6b21\u53d1\u751f\u3002\uff08D5\uff09<\/p>\n

A\u578b\u900f\u6790\u5668\u53cd\u5e94\u4e3b\u8981\u53d1\u75c5\u673a\u5236\u4e3a\u5feb\u901f\u7684\u53d8\u6001\u53cd\u5e94\uff1b\u5e38\u4e8e\u900f\u6790\u5f00\u59cb\u540e5 min\u5185\u53d1\u751f\uff0c\u5c11\u6570\u8fdf\u81f3\u900f\u6790\u5f00\u59cb\u540e30 min\uff0c\u53d1\u751f\u7387<5\u6b21\/10 000\u900f\u6790\u4f8b\u6b21\u3002\u4f9d\u636e\u53cd\u5e94\u8f7b\u91cd\u53ef\u8868\u73b0\u4e3a\u76ae\u80a4\u7619\u75d2\u3001\u8368\u9ebb\u75b9\u3001\u54b3\u55fd\u3001\u55b7\u568f\u3001\u6d41\u6e05\u6d95\u3001\u8179\u75db\u3001\u8179\u6cfb\uff0c\u751a\u81f3\u547c\u5438\u56f0\u96be\u3001\u4f11\u514b\u3001\u6b7b\u4ea1\u7b49\u3002<\/p>\n

\uff081\uff09\u7d27\u6025\u5904\u7406\uff1a\u2460\u7acb\u5373\u505c\u6b62\u900f\u6790\uff0c\u5939\u95ed\u8840\u8def\u7ba1\uff0c\u4e22\u5f03\u7ba1\u8def\u548c\u900f\u6790\u5668\u4e2d\u8840\u6db2\uff1b\u2461\u7ed9\u4e88\u6297\u7ec4\u80fa\u836f\u3001\u7cd6\u76ae\u8d28\u6fc0\u7d20\u6216\u80be\u4e0a\u817a\u7d20\u6cbb\u7597\uff1b\u2462\u5982\u51fa\u73b0\u547c\u5438\u5faa\u73af\u969c\u788d\uff0c\u7acb\u5373\u7ed9\u4e88\u5fc3\u810f\u547c\u5438\u652f\u6301\u6cbb\u7597\u3002<\/p>\n

\uff082\uff09\u660e\u786e\u75c5\u56e0\uff1a\u4e3b\u8981\u662f\u60a3\u8005\u5bf9\u4e0e\u8840\u6db2\u63a5\u89e6\u7684\u4f53\u5916\u5faa\u73af\u7ba1\u8def\u3001\u900f\u6790\u819c\u7b49\u53d1\u751f\u53d8\u6001\u53cd\u5e94\u6240\u81f4\uff0c\u53ef\u80fd\u7684\u81f4\u75c5\u56e0\u7d20\u5305\u62ec\u900f\u6790\u819c\u6750\u6599\u3001\u7ba1\u8def\u548c\u900f\u6790\u5668\u7684\u6d88\u6bd2\u5242\uff08\u5982\u73af\u6c27\u4e59\u70f7\uff09\u3001\u900f\u6790\u5668\u590d\u7528\u7684\u6d88\u6bd2\u6db2\u3001\u900f\u6790\u6db2\u53d7\u6c61\u67d3\u3001\u809d\u7d20\u8fc7\u654f\u7b49\u3002\u53e6\u5916\uff0c\u6709\u8fc7\u654f\u75c5\u53f2\u53ca\u9ad8\u55dc\u9178\u7ec6\u80de\u8840\u75c7\u3001\u8840\u7ba1\u7d27\u5f20\u7d20\u8f6c\u5316\u9176\u6291\u5236\u5242\uff08ACEI\uff09\u5e94\u7528\u8005\uff0c\u4e5f\u6613\u51fa\u73b0A\u578b\u53cd\u5e94\u3002<\/p>\n

\uff083\uff09\u9884\u9632\u63aa\u65bd\uff1a\u2460\u900f\u6790\u524d\u5145\u5206\u51b2\u6d17\u900f\u6790\u5668\u548c\u8840\u8def\u7ba1\uff1b\u2461\u9009\u7528\u84b8\u6c7d\u6216\u03b3\u5c04\u7ebf\u6d88\u6bd2\u900f\u6790\u5668\u548c\u8840\u8def\u7ba1\uff1b\u2462\u590d\u7528\u900f\u6790\u5668\uff1b\u2463\u5bf9\u4e8e\u9ad8\u5371\u4eba\u7fa4\u53ef\u4e8e\u900f\u6790\u524d\u5e94\u7528\u6297\u7ec4\u80fa\u836f\u7269\uff0c\u5e76\u505c\u7528ACEI\u7c7b\u836f\u7269\u3002<\/p>\n

2. B\u578b\u900f\u6790\u5668\u53cd\u5e94<\/p>\n

\u63a8\u8350\u610f\u89c150\uff1a\u53d1\u751fB\u578b\u900f\u6790\u5668\u53cd\u5e94\uff0c\u5e94\u9996\u5148\u6392\u9664\u5fc3\u8840\u7ba1\u75be\u75c5\uff0c\u5e76\u5bfb\u627e\u8bf1\u56e0\uff0c\u5bf9\u75c7\u6cbb\u7597\uff0c\u91c7\u53d6\u9884\u9632\u63aa\u65bd\u907f\u514d\u518d\u6b21\u53d1\u751f\u3002\uff08D5\uff09<\/p>\n

B\u578b\u53cd\u5e94\u53d1\u75c5\u673a\u5236\u591a\u8ba4\u4e3a\u662f\u8865\u4f53\u6fc0\u6d3b\u6240\u81f4\uff0c\u4e0e\u4f7f\u7528\u65b0\u7684\u8840\u6ee4\u5668\/\u900f\u6790\u5668\u548c\uff08\u6216\uff09\u751f\u7269\u76f8\u5bb9\u6027\u5dee\u7684\u8840\u6ee4\u5668\/\u900f\u6790\u5668\u76f8\u5173\u3002\u5e38\u4e8e\u900f\u6790\u5f00\u59cb\u540e20~60 min\u51fa\u73b0\uff0c\u5176\u53d1\u4f5c\u7a0b\u5ea6\u5e38\u8f83\u8f7b\uff0c\u591a\u8868\u73b0\u4e3a\u80f8\u75db\u548c\u80cc\u75db\u3002<\/p>\n

\uff081\uff09\u660e\u786e\u75c5\u56e0\uff1aHDF\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u51fa\u73b0\u80f8\u75db\u548c\u80cc\u75db\uff0c\u9996\u5148\u5e94\u6392\u9664\u5fc3\u8840\u7ba1\u75be\u75c5\uff08\u5982\u5fc3\u7ede\u75db\u3001\u5fc3\u5305\u708e\u7b49\uff09\uff0c\u7136\u540e\u518d\u8003\u8651B\u578b\u900f\u6790\u5668\u53cd\u5e94\uff0c\u5e76\u5bfb\u627e\u53ef\u80fd\u7684\u8bf1\u56e0\u3002<\/p>\n

\uff082\uff09\u5904\u7406\uff1aB\u578b\u900f\u6790\u5668\u53cd\u5e94\u591a\u8f83\u8f7b\uff0c\u7ed9\u4e88\u9f3b\u5bfc\u7ba1\u5438\u6c27\u53ca\u5bf9\u75c7\u5904\u7406\u5373\u53ef\uff0c\u5e38\u65e0\u9700\u7ec8\u6b62HDF\u6cbb\u7597\u3002<\/p>\n

\uff083\uff09\u9884\u9632\uff1a\u590d\u7528\u900f\u6790\u5668\u6216\u9009\u62e9\u751f\u7269\u76f8\u5bb9\u6027\u597d\u7684\u8840\u6ee4\u5668\/\u900f\u6790\u5668\u53ef\u9884\u9632\u90e8\u5206B\u578b\u900f\u6790\u5668\u53cd\u5e94\u3002<\/p>\n

\u4e8c\u3001\u8017\u635f\u7efc\u5408\u5f81<\/p>\n

\u63a8\u8350\u610f\u89c151\uff1a\u5efa\u8bae\u5bf9\u63a5\u53d7HDF\u6cbb\u7597\u7684\u60a3\u8005\u6bcf3~6\u4e2a\u6708\u8fdb\u884c\u8425\u517b\u72b6\u6001\u8bc4\u4f30\uff0c\u5e76\u52a0\u5f3a\u8425\u517b\u6cbb\u7597\u3002\uff08D5\uff09<\/p>\n

\uff08\u4e00\uff09\u75c5\u56e0<\/p>\n

HDF\u65f6\u4f7f\u7528\u8840\u6ee4\u5668\u6216\u9ad8\u901a\u91cf\u900f\u6790\u5668\uff0c\u53ef\u5f15\u8d77\u767d\u86cb\u767d\u4e22\u5931\uff0c\u5e76\u589e\u52a0\u53ef\u6eb6\u6027\u7ef4\u751f\u7d20\u3001\u5fae\u91cf\u5143\u7d20\u548c\u5c0f\u5206\u5b50\u591a\u80bd\u7b49\u7269\u8d28\u7684\u4e22\u5931\u3002\u4f46\u662f\uff0cHDF\u8425\u517b\u72b6\u51b5\u65b9\u9762\u7684\u6570\u636e\u6709\u9650\u4e14\u7ed3\u8bba\u4e0d\u4e00\u81f4\uff3b90\uff3d<\/sup>\u3002\u867d\u7136\u968f\u673a\u8bd5\u9a8c\u663e\u793aHDF\u4e0d\u4f1a\u5f71\u54cd\u767d\u86cb\u767d\u6c34\u5e73\u548c\u4f53\u91cd\uff3b4, 5\uff0c27\uff3d<\/sup>\uff0c\u4f46\u53ef\u5f15\u8d77\u6807\u51c6\u5316\u86cb\u767d\u5206\u89e3\u4ee3\u8c22\u7387\u589e\u52a0\uff3b5\uff3d<\/sup>\u3002<\/p>\n

\uff08\u4e8c\uff09\u8425\u517b\u72b6\u6001\u8bc4\u4f30\u4e0e\u76d1\u6d4b<\/p>\n

1. \u8425\u517b\u72b6\u6001\u8bc4\u4f30\uff1a\uff081\uff09\u4e34\u5e8a\u8c03\u67e5\uff1a\u75c5\u53f2\u3001\u4f53\u683c\u68c0\u67e5\u3001\u793e\u4f1a\u5fc3\u7406\u8c03\u67e5\u7b49\uff1b\uff082\uff09\u996e\u98df\u8bc4\u4f30\uff1a\u4f20\u7edf\u91c7\u7528\u4e09\u65e5\u996e\u98df\u8bb0\u5f55\u6cd5\uff0c\u8bb0\u5f55\u6bcf\u65e5\u6444\u5165\u98df\u7269\u79cd\u7c7b\u548c\u91cf\uff1b\uff083\uff09\u4eba\u4f53\u6d4b\u91cf\uff1a\u5305\u62ec\u65e0\u6c34\u80bf\u4f53\u91cd\u3001\u4f53\u8d28\u6307\u6570\u3001\u80b1\u4e09\u5934\u808c\u76ae\u8936\u539a\u5ea6\u548c\u4e0a\u81c2\u808c\u56f4\u3001\u4eba\u4f53\u6210\u5206\u6d4b\u5b9a\u7b49\uff1b\uff084\uff09\u751f\u5316\u6307\u6807\uff1a\u5305\u62ec\u8840\u6e05\u767d\u86cb\u767d\u3001\u900f\u6790\u524d\u540e\u7684\u5c3f\u7d20\u6c2e\u3001\u524d\u767d\u86cb\u767d\u3001\u8f6c\u94c1\u86cb\u767d\u3001\u8840\u8102\uff0c\u6709\u6761\u4ef6\u65f6\u53ef\u6d4b\u5b9a\u80f0\u5c9b\u7d20\u6837\u751f\u957f\u56e0\u5b50-1\uff1b\uff085\uff09\u4e3b\u89c2\u7efc\u5408\u6027\u8bc4\u4f30\uff1a\u5e94\u7528\u4e3b\u89c2\u7efc\u5408\u8425\u517b\u8bc4\u4f30\uff08SGA\uff09\u53ca\u8425\u517b\u4e0d\u826f\u708e\u75c7\u8bc4\u5206\u6cd5\uff08MIS\uff09\u8fdb\u884c\u8bc4\u4ef7\u3002<\/p>\n

2. \u8425\u517b\u72b6\u6001\u76d1\u6d4b\uff1a\u5efa\u8bae\u6bcf3~6\u4e2a\u67081\u6b21\u8bc4\u4f30\u60a3\u8005\u7684\u8425\u517b\u72b6\u6001\u3002<\/p>\n

3. \u8425\u517b\u6cbb\u7597\uff1a\u76ee\u524d\u5173\u4e8eHDF\u8017\u635f\u7efc\u5408\u5f81\u6cbb\u7597\u7684\u8bc1\u636e\u6709\u9650\uff0c\u53c2\u80032020\u5e74\u7f8e\u56fd\u56fd\u5bb6\u80be\u810f\u57fa\u91d1\u4f1a\u80be\u75c5\u9884\u540e\u8d28\u91cf\u5021\u8bae\uff08KDOQI\uff09\u6307\u5357\uff3b91\uff3d<\/sup>\u3001\u6539\u5584\u5168\u7403\u80be\u810f\u75c5\u9884\u540e\u7ec4\u7ec7\uff08KDIGO\uff09\u6307\u5357\uff3b92\uff3d<\/sup>\u3001\u4e2d\u56fd\u6162\u6027\u80be\u810f\u75c5\u8425\u517b\u6cbb\u7597\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\uff3b93\uff3d<\/sup>\uff0c\u5efa\u8baeHDF\u60a3\u8005\u86cb\u767d\u8d28\u6444\u5165\u91cf\u4e3a1.0~1.2 g\u00b7kg-1<\/sup>\u00b7d-1<\/sup>\u3002\u56fd\u51855\u4e2a\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c273\u4f8b\u7ec8\u672b\u671f\u80be\u75c5\u60a3\u8005\u7684\u7cfb\u7edf\u7efc\u8ff0\u548c\u835f\u8403\u5206\u6790\u7ed3\u679c\u663e\u793a\uff0c\u4f4e\u86cb\u767d\u8d28\u996e\u98df\u5e76\u8865\u5145\u590d\u65b9\u03b1\u916e\u9178\u5236\u52420.12 g\u00b7kg-1<\/sup>\u00b7d-1<\/sup>\u53ef\u4ee5\u6539\u5584\u60a3\u8005\u8425\u517b\u72b6\u6001\uff3b94\uff3d<\/sup>\u3002<\/p>\n

\u4e09\u3001\u5e76\u53d1\u75c7\u9632\u6cbb\u7684\u533b\u7597\u8d28\u91cf\u63a7\u5236<\/p>\n

\u63a8\u8350\u610f\u89c152\uff1a\u5efa\u8baeHDF\u76f8\u5173\u5e76\u53d1\u75c7\u9632\u6cbb\u6309\u4ee5\u4e0b\u6307\u6807\u8fdb\u884c\u8d28\u91cf\u63a7\u5236\u3002\uff08D5\uff09<\/p>\n

1. HDF\u6cbb\u7597\u8fc7\u7a0b\u4e2d\u6025\u6027\u5e76\u53d1\u75c7\u53d1\u751f\u7387\uff1a\u5355\u4f4d\u65f6\u95f4\u5185\uff0c\u53d1\u751f\u6025\u6027\u5e76\u53d1\u75c7\uff08\u611f\u67d3\u3001\u4f53\u5916\u5faa\u73af\u51dd\u8840\u3001\u808c\u8089\u75c9\u631b\u53ca\u8840\u6ee4\u5668\/\u900f\u6790\u5668\u53cd\u5e94\u7b49\uff09\u7684HDF\u6cbb\u7597\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u7684\u6bd4\u4f8b\u3002<\/p>\n

2. HDF\u60a3\u8005\u8425\u517b\u72b6\u6001\u8bc4\u4f30\u5b8c\u6210\u7387\uff1a\u6bcf3~6\u4e2a\u6708\u5b8c\u6210\u8425\u517b\u72b6\u6001\u8bc4\u4f30HDF\u60a3\u8005\u5360\u63a5\u53d7HDF\u6cbb\u7597\u60a3\u8005\u6bd4\u4f8b\u3002<\/p>\n

\u7b2c\u4e5d\u90e8\u5206 HDF\u6cbb\u7597\u7684\u5c55\u671b<\/p>\n

\u4f17\u591a\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u8bc1\u5b9e\uff0c\u4e0e\u8840\u6db2\u900f\u6790\u6bd4\u8f83\uff0cHDF\u5177\u6709\u8840\u6d41\u52a8\u529b\u5b66\u7a33\u5b9a\u3001\u964d\u4f4e\u900f\u6790\u671f\u95f4\u4f4e\u8840\u538b\u53d1\u751f\u7387\u548c\u5fc3\u8840\u7ba1\u75c5\u6b7b\u4ea1\u7387\u3001\u63d0\u9ad8\u03b22-\u5fae\u7403\u86cb\u767d\u7b49\u4e2d\u5927\u5206\u5b50\u5c3f\u6bd2\u75c7\u6bd2\u7d20\u6e05\u9664\u7387\u548c\u900f\u6790\u5145\u5206\u6027\u7b49\u7279\u70b9\u30022023\u5e746\u6708\u53d1\u8868\u5728\u300a\u65b0\u82f1\u683c\u5170\u533b\u5b66\u6742\u5fd7\u300b\u76841 360\u4f8b\u63a5\u53d7\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u6cbb\u75973\u4e2a\u6708\u4ee5\u4e0a\u60a3\u8005\u7684\u56fd\u9645\u591a\u4e2d\u5fc3\u3001\u524d\u77bb\u6027\u3001\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u7ed3\u679c\u4e5f\u8fdb\u4e00\u6b65\u8bc1\u5b9e\uff0c\u4e2d\u4f4d\u968f\u8bbf30\u4e2a\u6708\u671f\u95f4\uff0c\u4e0e\u7ee7\u7eed\u8fdb\u884c\u9ad8\u901a\u91cf\u8840\u6db2\u900f\u6790\u60a3\u8005\u6bd4\u8f83\uff0c\u66f4\u6539\u4e3aHDF\uff08\u6bcf\u54683\u6b21\uff0c\u6bcf\u6b21\u22654 h\uff0c\u6bcf\u6b21\u7f6e\u6362\u6db2\u5242\u91cf25.3 L\uff09\u60a3\u8005\u7684\u5168\u56e0\u6b7b\u4ea1\u7387\uff08HR=0.77\uff0c95%CI\uff1a0.65~0.93\uff09\u3001\u975e\u5fc3\u8840\u7ba1\u75be\u75c5\u6b7b\u4ea1\u7387\uff08HR=0.76\uff0c95%CI\uff1a0.59~0.98\uff09\u548c\u5305\u62ec\u65b0\u578b\u51a0\u72b6\u75c5\u6bd2\u611f\u67d3\u7684\u76f8\u5173\u6b7b\u4ea1\u7387\uff08HR=0.69\uff0c95%CI\uff1a0.49~0.96\uff09\u663e\u8457\u964d\u4f4e\uff3b95\uff3d<\/sup>\u3002on-line HDF\u88ab\u8ba4\u4e3a\u662f\u6700\u5148\u8fdb\u548c\u6700\u9002\u5408\u7684\u4e34\u5e8a\u80be\u810f\u66ff\u4ee3\u6cbb\u7597\u6a21\u5f0f\uff0c\u4e34\u5e8a\u5e94\u7528\u65e5\u76ca\u589e\u591a\u3002\u4f46\u662f\uff0con-line HDF\u6cbb\u7597\u8fd8\u5b58\u5728\u8bb8\u591a\u4e9f\u5f85\u89e3\u51b3\u7684\u79d1\u5b66\u95ee\u9898\uff0c\u5305\u62econ-line HDF\u80fd\u591f\u6e05\u9664\u54ea\u4e9b\u5c3f\u6bd2\u75c7\u6bd2\u7d20\uff1f\u6e05\u9664\u7684\u5c3f\u6bd2\u75c7\u6bd2\u7d20\u5bf9\u60a3\u8005\u7684\u8d2b\u8840\u3001CKD-MBD\u4ee5\u53ca\u5fc3\u8840\u7ba1\u5e76\u53d1\u75c7\u7b49\u5177\u6709\u4ec0\u4e48\u75c5\u7406\u751f\u7406\u6548\u5e94\uff1fon-line HDF\u6cbb\u7597\u7684\u9002\u5408\u4eba\u7fa4\u4e0e\u542f\u52a8\u65f6\u673a\uff1f\u9002\u5408on-line HDF\u6cbb\u7597\u60a3\u8005\u7684\u8425\u517b\u6cbb\u7597\u65b9\u6848\u7b49\uff0c\u8feb\u5207\u9700\u8981\u5f00\u5c55\u76f8\u5173\u4e34\u5e8a\u57fa\u7840\u7814\u7a76\u548c\u5faa\u8bc1\u533b\u5b66\u7814\u7a76\u3002<\/p>\n

\u6b64\u5916\uff0c\u57fa\u4e8e\u4e2d\u56fd\u60a3\u8005\u7684on-line HDF\u7684\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u660e\u663e\u4e0d\u8db3\uff0c\u7279\u522b\u662f\u6bcf\u54681\u6b21\u7684on-line HDF\u6cbb\u7597\u53ef\u5426\u4f7f\u4e2d\u56fd\u60a3\u8005\u83b7\u5f97\u751f\u5b58\u83b7\u76ca\u4e5f\u4e9f\u5f85\u9610\u660e\u3002\u53e6\u5916\uff0c\u6211\u56fd\u5404\u5730\u533aon-line HDF\u5e94\u7528\u5dee\u8ddd\u660e\u663e\uff0c\u533b\u7597\u8d28\u91cf\u63a7\u5236\u521a\u521a\u8d77\u6b65\uff0c\u4e5f\u8feb\u5207\u9700\u8981\u52a0\u5f3aon-line HDF\u6cbb\u7597\u7684\u533b\u7597\u8d28\u91cf\u63a7\u5236\u7814\u7a76\u3002<\/p>\n

\u5e0c\u671b\u672c\u6307\u5357\u4e0d\u4ec5\u5bf9\u89c4\u8303on-line HDF\u6cbb\u7597\u548c\u63d0\u9ad8\u533b\u7597\u8d28\u91cf\u63d0\u4f9b\u6307\u5bfc\uff0c\u4e5f\u4e3a\u6211\u56fd\u5f00\u5c55on-line HDF\u7684\u4e34\u5e8a\u5faa\u8bc1\u533b\u5b66\u7814\u7a76\u63d0\u4f9b\u501f\u9274\u548c\u5e2e\u52a9\u3002\u540c\u65f6\uff0c\u5e0c\u671b\u6211\u56fd\u8840\u6db2\u51c0\u5316\u533b\u52a1\u5de5\u4f5c\u8005\u79ef\u7d2f\u771f\u5b9e\u4e16\u754c\u7684on-line HDF\u6cbb\u7597\u7ecf\u9a8c\u4ee5\u53ca\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\uff0c\u4e3a\u6307\u5357\u66f4\u65b0\u63d0\u4f9b\u8bc1\u636e\u652f\u6301\uff0c\u4e5f\u4e3a\u4f17\u591a\u5c3f\u6bd2\u75c7\u60a3\u8005\u63d0\u4f9b\u66f4\u597d\u7684\u533b\u7597\u670d\u52a1\u3002<\/p>\n

\u5229\u76ca\u51b2\u7a81<\/p>\n

\u6240\u6709\u4f5c\u8005\u58f0\u660e\u4e0d\u5b58\u5728\u5229\u76ca\u51b2\u7a81<\/p>\n

\u53c2\u8003\u6587\u732e\uff08\u4e0b\u6ed1\u67e5\u770b\uff09\uff1a<\/p>\n

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\u7248\u6743\u5f52\u4e2d\u534e\u533b\u5b66\u4f1a\u6240\u6709\u3002<\/p>\n

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\u9664\u975e\u7279\u522b\u58f0\u660e\uff0c\u672c\u520a\u520a\u51fa\u7684\u6240\u6709\u6587\u7ae0\u4e0d\u4ee3\u8868\u4e2d\u534e\u533b\u5b66\u4f1a\u548c\u672c\u520a\u7f16\u59d4\u4f1a\u7684\u89c2\u70b9\u3002<\/p>\n

\u6765\u6e90\uff1a\u4e2d\u56fd\u533b\u5e08\u534f\u4f1a\u80be\u810f\u5185\u79d1\u533b\u5e08\u5206\u4f1a\u8840\u6db2\u900f\u6790\u6ee4\u8fc7\u8d28\u63a7\u6307\u5357\u5de5\u4f5c\u7ec4. \u8840\u6db2\u900f\u6790\u6ee4\u8fc7\u8d28\u91cf\u63a7\u5236\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357 [J] . \u4e2d\u534e\u533b\u5b66\u6742\u5fd7, 2024, 104(8) : 571-593. DOI: 10.3760\/cma.j.cn112137-20231212-01361.<\/p>\n","protected":false},"excerpt":{"rendered":"

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