{"id":44512,"date":"2024-12-03T05:11:06","date_gmt":"2024-12-03T05:11:06","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=44512"},"modified":"2024-12-03T05:11:06","modified_gmt":"2024-12-03T05:11:06","slug":"%e3%80%90%e4%b8%93%e5%ae%b6%e5%85%b1%e8%af%86%e3%80%91%e8%bf%9e%e7%bb%ad%e6%80%a7%e8%82%be%e6%9b%bf%e4%bb%a3%e6%b2%bb%e7%96%97%e5%ae%b9%e9%87%8f%e8%af%84%e4%bc%b0%e4%b8%8e%e7%ae%a1%e7%90%86%e4%b8%93","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=44512","title":{"rendered":"\u3010\u4e13\u5bb6\u5171\u8bc6\u3011\u8fde\u7eed\u6027\u80be\u66ff\u4ee3\u6cbb\u7597\u5bb9\u91cf\u8bc4\u4f30\u4e0e\u7ba1\u7406\u4e13\u5bb6\u5171\u8bc6"},"content":{"rendered":"

\u4e2d\u534e\u533b\u5b66\u4f1a\u80be\u810f\u75c5\u5b66\u5206\u4f1a\u4e13\u5bb6\u7ec4<\/p>\n

\u901a\u4fe1\u4f5c\u8005\uff1a\u9648\u6c5f\u534e\uff0c\u6d59\u6c5f\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u7b2c\u4e00\u533b\u9662\u80be\u810f\u75c5\u4e2d\u5fc3\uff0c\u6d59\u6c5f\u5927\u5b66\u80be\u810f\u75c5\u7814\u7a76\u6240\uff0c\u6d59\u6c5f\u7701\u80be\u810f\u75c5\u9632\u6cbb\u6280\u672f\u7814\u7a76\u91cd\u70b9\u5b9e\u9a8c\u5ba4\uff0c\u676d\u5dde 310003\uff0cEmail\uff1achenjianghua@zju.edu.cn<\/p>\n

DOI\uff1a10.3760\/cma.j.cn441217-20230911-00911<\/p>\n

\u6458 \u8981 \u8fd1\u5e74\u6765\u7684\u7814\u7a76\u8868\u660e\uff0c\u5bb9\u91cf\u8fc7\u8d1f\u8377\u662f\u5408\u5e76\u6025\u6027\u80be\u635f\u4f24\uff08acute kidney injury\uff0cAKI\uff09\u3001\u6025\u6027\u547c\u5438\u7a98\u8feb\u7efc\u5408\u5f81\u6216\u8113\u6bd2\u75c7\u7684\u91cd\u75c7\u60a3\u8005\u80be\u810f\u529f\u80fd\u635f\u5bb3\u52a0\u91cd\u3001\u80be\u529f\u80fd\u6062\u590d\u7387\u964d\u4f4e\u548c\u75c5\u6b7b\u7387\u589e\u52a0\u7684\u72ec\u7acb\u5371\u9669\u56e0\u7d20\u3002\u5bb9\u91cf\u8fc7\u8d1f\u8377\u5bf9\u80be\u529f\u80fd\u7684\u635f\u5bb3\u53ef\u80fd\u4e0e\u80be\u9759\u8109\u9ad8\u538b\u3001\u80be\u95f4\u8d28\u6c34\u80bf\u6709\u5173\uff0c\u5e76\u6700\u7ec8\u5bfc\u81f4\u80be\u8840\u6d41\u91cf\u548c\u80be\u5c0f\u7403\u6ee4\u8fc7\u7387\u4e0b\u964d\u3002\u7136\u800c\uff0c\u901a\u8fc7\u5229\u5c3f\u5242\u6216\u8fde\u7eed\u6027\u80be\u66ff\u4ee3\u6cbb\u7597\uff08continuous renal replacement therapy\uff0cCRRT\uff09\u8fdb\u884c\u6db2\u4f53\u6e05\u9664\u4f1a\u589e\u52a0\u60a3\u8005\u8840\u5bb9\u91cf\u4e0d\u8db3\u3001\u8840\u6d41\u52a8\u529b\u5b66\u4e0d\u7a33\u5b9a\u3001\u7ec4\u7ec7\u5668\u5b98\u704c\u6ce8\u4e0d\u8db3\u7b49\u98ce\u9669\u3002\u56e0\u6b64\uff0cCRRT\u671f\u95f4\u5bf9AKI\u60a3\u8005\u8fdb\u884c\u51c6\u786e\u7684\u5bb9\u91cf\u72b6\u6001\u8bc4\u4f30\u4e0e\u7ba1\u7406\u81f3\u5173\u91cd\u8981\u3002\u4e2d\u534e\u533b\u5b66\u4f1a\u80be\u810f\u75c5\u5b66\u5206\u4f1a\u4e13\u5bb6\u7ec4\u57fa\u4e8e\u5faa\u8bc1\u533b\u5b66\u8bc1\u636e\u53ca\u4e34\u5e8a\u7ecf\u9a8c\u5236\u5b9a\u4e86\u300aCRRT\u5bb9\u91cf\u8bc4\u4f30\u4e0e\u7ba1\u7406\u4e13\u5bb6\u5171\u8bc6\u300b\u3002\u4e13\u5bb6\u7ec4\u901a\u8fc7\u5bf9\u6b64\u9886\u57df\u7cfb\u7edf\u5168\u9762\u7684\u6587\u732e\u68c0\u7d22\u3001\u6570\u636e\u5206\u6790\u53ca\u4e13\u4e1a\u8ba8\u8bba\uff0c\u6784\u5efa\u4e865\u4e2aCRRT\u5bb9\u91cf\u7ba1\u7406\u7684\u4e13\u9898\uff1aAKI\u60a3\u8005\u5bb9\u91cf\u5931\u8861\u7684\u75c5\u7406\u751f\u7406\u5b66\u57fa\u7840\u53ca\u5371\u5bb3\u3001AKI\u60a3\u8005\u5bb9\u91cf\u7ba1\u7406\u7b56\u7565\u3001AKI\u60a3\u8005\u5bb9\u91cf\u72b6\u6001\u53ca\u53cd\u5e94\u6027\u8bc4\u4f30\u3001CRRT\u5bb9\u91cf\u7ba1\u7406\u7684\u5206\u7ea7\u4e0e\u5e94\u7528\u548cCRRT\u5bb9\u91cf\u7ba1\u7406\u76ee\u6807\u5236\u5b9a\u4e0eCRRT\u5904\u65b9\u3002\u8be5\u5171\u8bc6\u65e8\u5728\u89c4\u8303\u4e34\u5e8a\u64cd\u4f5c\uff0c\u964d\u4f4eAKI\u60a3\u8005\u5bb9\u91cf\u5931\u8861\u7684\u53d1\u751f\u7387\u5e76\u6539\u5584\u5176\u9884\u540e\u3002\u5173\u952e\u8bcd \u8fde\u7eed\u6027\u80be\u66ff\u4ee3\u7597\u6cd5\uff1b\u6025\u6027\u80be\u635f\u4f24\uff1b\u8840\u91cf\uff1b\u8840\u6d46\u5bb9\u91cf\uff1b\u8840\u5bb9\u91cf\u4e0d\u8db3\uff1b\u5bb9\u91cf\u8bc4\u4f30\u4e0e\u7ba1\u7406\uff1b\u4e13\u5bb6\u5171\u8bc6<\/p>\n

<\/h2>\n

\u4e00\u3001 \u524d\u8a00<\/h2>\n

\u8fde\u7eed\u6027\u80be\u66ff\u4ee3\u6cbb\u7597\uff08continuous renal replacement therapy\uff0cCRRT\uff09\u662f\u4e34\u5e8a\u5e38\u7528\u7684\u8840\u6db2\u51c0\u5316\u6280\u672f\uff0c\u5728\u91cd\u75c7\u6025\u6027\u80be\u635f\u4f24\uff08acute kidney injury\uff0cAKI\uff09\u3001\u65b0\u578b\u51a0\u72b6\u75c5\u6bd2\u80ba\u708e\u3001\u8113\u6bd2\u75c7\u3001\u91cd\u75c7\u6025\u6027\u80f0\u817a\u708e\u3001\u6025\u6027\u4e2d\u6bd2\u7b49\u591a\u79cd\u75be\u75c5\u6cbb\u7597\u4e2d\u53d1\u6325\u7740\u5173\u952e\u4f5c\u7528\u3002\u57fa\u4e8e\u5317\u4eac\u5e0230\u5bb6\u533b\u96623 107\u4f8b\u5371\u91cd\u75c5\u60a3\u8005\u4e34\u5e8a\u8d44\u6599\u7684\u7814\u7a76\u663e\u793a\uff0c\u82e5\u6839\u636e2012\u5e74\u6539\u5584\u5168\u7403\u80be\u810f\u75c5\u9884\u540e\u7ec4\u7ec7\uff08Kidney Disease\uff1aImproving Global Outcomes\uff0cKDIGO\uff09\u53d1\u5e03\u7684\u8bca\u65ad\u6807\u51c6\uff0c\u5317\u4eac\u5730\u533a\u5371\u91cd\u75c7\u60a3\u8005AKI\u53d1\u751f\u7387\u4e3a51%\uff3b1\uff3d<\/sup>\u3002\u91cd\u75c7AKI\u60a3\u8005\u5408\u5e76\u5bb9\u91cf\u8fc7\u8d1f\u8377\uff08fluid overload\uff0cFO\uff09\u7684\u6bd4\u4f8b\u8d85\u8fc760%\uff3b2-3\uff3d<\/sup>\u3002\u65e9\u671f\u53ca\u65f6\u5145\u5206\u7684\u6db2\u4f53\u590d\u82cf\u80fd\u591f\u8865\u5145\u8840\u5bb9\u91cf\uff0c\u4fdd\u8bc1\u80be\u704c\u6ce8\uff0c\u51cf\u5c11AKI\u7684\u53d1\u751f\uff0c\u4f46FO\u53ef\u52a0\u91cd\u80be\u810f\u8d1f\u62c5\uff0c\u5bfc\u81f4AKI\u7684\u53d1\u751f\u6216\u52a0\u91cd\uff0c\u589e\u52a0\u60a3\u8005\u6b7b\u4ea1\u98ce\u9669\uff3b4-6\uff3d<\/sup>\u3002CRRT\u4f5c\u4e3a\u6025\u5371\u91cd\u75c7\u60a3\u8005\u6cbb\u7597\u7684\u91cd\u8981\u624b\u6bb5\u76ee\u524d\u5df2\u5e7f\u6cdb\u5e94\u7528\u4e8e\u4e34\u5e8a\uff0c\u4f46\u5728\u64cd\u4f5c\u4e0e\u5b9e\u65bd\u8fc7\u7a0b\u4e2d\u4ecd\u6709\u4e0d\u540c\u7684\u8ba4\u8bc6\uff0c\u56e0\u6b64\u6709\u5fc5\u8981\u5f62\u6210\u5171\u8bc6\uff0c\u4ee5\u89c4\u8303\u4e34\u5e8a\u64cd\u4f5c\uff0c\u51c6\u786e\u8bc4\u4f30\u60a3\u8005\u5bb9\u91cf\uff0c\u7ef4\u6301\u8840\u6d41\u52a8\u529b\u5b66\u7a33\u5b9a\uff0c\u964d\u4f4e\u60a3\u8005\u75c5\u6b7b\u7387\u3002<\/p>\n

\u4e8c\u3001 \u5171\u8bc6\u5f62\u6210<\/h2>\n

2020\u5e745\u6708\u4e2d\u534e\u533b\u5b66\u4f1a\u80be\u810f\u75c5\u5b66\u5206\u4f1a\u6210\u7acb\u4e86\u201cCRRT\u5bb9\u91cf\u8bc4\u4f30\u4e0e\u7ba1\u7406\u4e13\u5bb6\u5171\u8bc6\u5c0f\u7ec4\u201d\u3002\u8be5\u4e13\u5bb6\u7ec4\u7531\u80be\u810f\u5185\u79d1\u53ca\u91cd\u75c7\u533b\u5b66\u79d1\u7684\u4e34\u5e8a\u4e13\u5bb6\u7ec4\u6210\uff0c\u901a\u8fc7\u591a\u6b21\u7f51\u7edc\u4f1a\u8bae\u8ba8\u8bba\u3001\u95ee\u5377\u8c03\u67e5\u7b49\u5f62\u5f0f\uff0c\u62df\u5b9a\u4e86\u9700\u8981\u89e3\u51b3\u7684\u91cd\u8981\u4e34\u5e8a\u95ee\u9898\uff0c\u6700\u7ec8\u786e\u5b9a\u4e86\u201cCRRT\u5bb9\u91cf\u8bc4\u4f30\u4e0e\u7ba1\u7406\u5171\u8bc6\u201d\u3002\u8be5\u5171\u8bc6\u5305\u62ec\u4ee5\u4e0b5\u65b9\u9762\u5185\u5bb9\uff1a\uff081\uff09AKI\u60a3\u8005\u5bb9\u91cf\u5931\u8861\u7684\u75c5\u7406\u751f\u7406\u5b66\u57fa\u7840\u53ca\u5371\u5bb3\uff1b\uff082\uff09AKI\u60a3\u8005\u5bb9\u91cf\u7ba1\u7406\u7b56\u7565\uff1b\uff083\uff09AKI\u60a3\u8005\u5bb9\u91cf\u72b6\u6001\u53ca\u53cd\u5e94\u6027\u8bc4\u4f30\uff1b\uff084\uff09CRRT\u5bb9\u91cf\u7ba1\u7406\u7684\u5206\u7ea7\u4e0e\u5e94\u7528\uff1b\uff085\uff09CRRT\u5bb9\u91cf\u7ba1\u7406\u76ee\u6807\u5236\u5b9a\u4e0eCRRT\u5904\u65b9\u3002\u6bcf\u4e2a\u4e13\u9898\u7531\u6267\u7b14\u4e13\u5bb6\u8d1f\u8d23\u67e5\u9605\u76f8\u5173\u6587\u732e\uff0c\u7ed3\u5408\u81ea\u5df1\u7684\u4e34\u5e8a\u7ecf\u9a8c\uff0c\u6536\u96c6\u5171\u8bc6\u6761\u76ee\uff0c\u5f62\u6210\u521d\u7a3f\uff0c\u5e76\u7ecf\u4e2d\u534e\u533b\u5b66\u4f1a\u80be\u810f\u75c5\u5b66\u5206\u4f1a\u4e13\u5bb6\u7ec4\u8ba8\u8bba\u3001\u5ba1\u5b9a\u3002\u5171\u8bc6\u63a8\u8350\u5f3a\u5ea6\u4e0e\u7b49\u7ea7\u53c2\u8003\u4e86\u4e34\u5e8a\u6307\u5357\u5236\u5b9a\u4e2d\u63a8\u8350\u610f\u89c1\u5206\u7ea7\u7684\u8bc4\u4f30\u3001\u5236\u5b9a\u53ca\u8bc4\u4ef7\uff08grading of recommendations assessment\uff0c development and evaluation\uff0cGRADE\uff09\u65b9\u6cd5\uff3b7\uff3d<\/sup>\u3002\u8bc1\u636e\u8d28\u91cf\u5206\u4e3aA\u3001B\u3001C\u3001D\uff08\u7531\u9ad8\u5230\u4f4e\uff094\u4e2a\u7ea7\u522b\uff08\u88681\uff09\uff0c\u63a8\u8350\u610f\u89c1\u5206\u4e3a\u5f3a\u63a8\u8350\u3001\u5f31\u63a8\u8350\u6216\u65e0\u63a8\u8350\uff08\u88681\uff09\u3002<\/p>\n

\u4e09\u3001 AKI\u60a3\u8005\u5bb9\u91cf\u5931\u8861\u7684\u75c5\u7406\u751f\u7406\u5b66\u57fa\u7840\u53ca\u5371\u5bb3<\/h2>\n

AKI\u5df2\u6210\u4e3a\u6211\u56fd\u5de8\u5927\u7684\u533b\u7597\u8d1f\u62c5\uff0c2013\u5e74\u4e2d\u56fd\u4f4f\u9662\u60a3\u8005\u4e2dAKI\u6f0f\u8bca\u7387\u9ad8\u8fbe74.2%\uff0c\u9700\u8981\u63a5\u53d7CRRT\u6cbb\u7597\u7684AKI\u60a3\u8005\u53ea\u670959.3%\u5f97\u5230\u6551\u6cbb\uff0c\u5bfc\u81f4\u9662\u5185\u75c5\u6b7b\u7387\u663e\u8457\u589e\u52a0\uff3b8\uff3d<\/sup>\u3002\u56e0\u6b64\uff0c\u65e9\u671f\u8bc6\u522b\u548c\u9884\u8b66AKI\u7684\u53d1\u751f\uff0c\u9488\u5bf9\u53ef\u9006\u75c5\u56e0\u8fdb\u884c\u53ca\u65f6\u5e72\u9884\u662f\u9632\u6cbbAKI\u7684\u5173\u952e\u73af\u8282\u3002\u6c34\u662f\u4eba\u4f53\u6700\u91cd\u8981\u7684\u7ec4\u6210\u90e8\u5206\uff0c\u5360\u4f53\u91cd\u768455%\uff5e60%\u3002\u5176\u4e2d\uff0c\u7ec6\u80de\u5185\u6db2\u7ea6\u5360\u4f53\u91cd35%\uff5e40%\uff0c\u7ec6\u80de\u5916\u6db2\u536020%\uff08\u7ec4\u7ec7\u95f4\u6db215%\uff0c\u8840\u6d465%\uff09\u3002\u76ee\u524d\u8ba4\u4e3a\u8113\u6bd2\u75c7\u548c\u4f4e\u8840\u5bb9\u91cf\u662f\u8bf1\u53d1AKI\u76842\u4e2a\u5e38\u89c1\u539f\u56e0\uff0c\u5176\u75c5\u7406\u751f\u7406\u673a\u5236\u662f\u673a\u4f53\u5bb9\u91cf\u7684\u76f8\u5bf9\u6216\u7edd\u5bf9\u4e0d\u8db3\u5bfc\u81f4\u80be\u810f\u4f4e\u704c\u6ce8\u548c\u7f3a\u6c27\uff0c\u4ece\u800c\u5f15\u8d77\u6025\u6027\u80be\u5c0f\u7ba1\u574f\u6b7b\u548c\u7ec6\u80de\u635f\u4f24\u3002AKI\u65e9\u671f\u662f\u53ef\u9006\u7684\uff0c\u56e0\u6b64\u53ca\u65f6\u5145\u5206\u7684\u6db2\u4f53\u590d\u82cf\u80fd\u591f\u6062\u590d\u6709\u6548\u5faa\u73af\u5bb9\u91cf\u548c\u7a00\u91ca\u80be\u6bd2\u6027\u7269\u8d28\uff0c\u7ef4\u6301\u80be\u810f\u704c\u6ce8\u538b\uff0c\u907f\u514d\u7f3a\u8840\u7f3a\u6c27\u6027\u635f\u4f24\uff3b9-10\uff3d<\/sup>\u3002\u5bb9\u91cf\u7ba1\u7406\u5bf9\u91cd\u75c7AKI\u60a3\u8005\u662f\u4e00\u628a\u201c\u53cc\u5203\u5251\u201d\u3002\u5f53\u7d2f\u79ef\u7684\u4f53\u6db2\u91cf\u6216\u4f53\u91cd\u589e\u52a0\u8d85\u8fc7\u57fa\u7ebf\u4f53\u91cd10\uff05\u65f6\u5b9a\u4e49\u4e3aFO\uff0c\u5b83\u53ef\u663e\u8457\u964d\u4f4e\u60a3\u8005\u80be\u529f\u80fd\u6062\u590d\u7387\uff0c\u5ef6\u957f\u673a\u68b0\u8f85\u52a9\u901a\u6c14\u65f6\u95f4\uff0c\u589e\u52a0\u4f4f\u9662\u65f6\u95f4\u548c\u75c5\u6b7b\u7387\uff1bCRRT\u8d85\u6ee4\u8fc7\u591a\u6216\u8fc7\u5feb\u5bb9\u6613\u5bfc\u81f4\u8840\u5bb9\u91cf\u4e0d\u8db3\uff0c\u5f15\u8d77\u7ec4\u7ec7\u704c\u6ce8\u4e0d\u8db3\uff0c\u5668\u5b98\u7f3a\u8840\u7f3a\u6c27\uff3b9\uff3d<\/sup>\u3002\u53e6\u5916\uff0cFO\u53ef\u4ee5\u901a\u8fc7\u591a\u79cd\u673a\u5236\u5bfc\u81f4\u7ec8\u672b\u5668\u5b98\u529f\u80fd\u4e0d\u5168\u3002\u5176\u4e2d\uff0c\u80be\u810f\u529f\u80fd\u5728FO\u7684\u75c5\u7406\u751f\u7406\u5b66\u65b9\u9762\u8d77\u5173\u952e\u4f5c\u7528\u3002AKI\u4e0d\u4ec5\u5f71\u54cd\u6db2\u4f53\u548c\u6eb6\u8d28\u6e05\u9664\uff0c\u53cd\u8fc7\u6765\u4e5f\u53ef\u56e0\u95f4\u8d28\u6c34\u80bf\u548c\u9ad8\u4e2d\u5fc3\u9759\u8109\u538b\uff08central venous pressure\uff0cCVP\uff09\u52a0\u91cdAKI\u3002\u8f83\u9ad8\u7684CVP\uff0c\u901a\u8fc7\u964d\u4f4e\u80ba\u7684\u6dcb\u5df4\u5f15\u6d41\uff0c\u5bfc\u81f4\u80ba\u6c34\u80bf\uff0c\u5f71\u54cd\u6c14\u4f53\u4ea4\u6362\u30022006\u5e74\u6b27\u6d32\u6025\u6027\u60a3\u8005\u8113\u6bd2\u75c7\u53d1\u751f\uff08sepsis occurrence in acutely ill patients\uff0cSOAP\uff09\u7814\u7a76\u7eb3\u51651 177\u4f8b\u8113\u6bd2\u75c7\u60a3\u8005\uff0c\u53d1\u73b0\u8113\u6bd2\u6027\u4f11\u514b\u53d1\u751f\u540e72 h\u5185\u7684\u7d2f\u79ef\u5bb9\u91cf\u5e73\u8861\u91cf\u4e0e\u91cd\u75c7\u76d1\u62a4\u75c5\u623f\uff08intensive care unit\uff0cICU\uff09\u75c5\u6b7b\u7387\u663e\u8457\u76f8\u5173\uff3b11\uff3d<\/sup>\u3002\u56e0\u6b64\uff0cFO\u53d1\u751f\u662f\u91cd\u75c7AKI\u60a3\u8005\u542f\u52a8CRRT\u6cbb\u7597\u7684\u65f6\u95f4\u7a97\u3002<\/p>\n

\u56db\u3001 AKI\u60a3\u8005CRRT\u6cbb\u7597\u7684\u5bb9\u91cf\u7ba1\u7406<\/h2>\n

\uff08\u4e00\uff09 AKI\u60a3\u8005CRRT\u5bb9\u91cf\u7ba1\u7406\u7b56\u7565<\/h3>\n

1. CRRT\u6cbb\u7597\u524d\u9996\u5148\u8bc4\u4f30\u60a3\u8005\u5bb9\u91cf\u72b6\u6001\u53ca\u5bb9\u91cf\u53cd\u5e94\u6027\uff1b\u4f7f\u7528\u6700\u5c11\u7684\u8865\u6db2\u91cf\u7ef4\u6301\u6709\u6548\u80be\u704c\u6ce8\u548c\u5faa\u73af\u8840\u5bb9\u91cf\uff0c\u6539\u5584\u5168\u8eab\u7ec4\u7ec7\u6c27\u5408\uff0c\u540c\u65f6\u907f\u514d\u95f4\u8d28\u548c\u7ec4\u7ec7\u6c34\u80bf\u30022. \u8bbe\u5b9aCRRT\u8d85\u6ee4\u76ee\u6807\u91cf\u4ee5\u8fbe\u5230\u5bb9\u91cf\u5e73\u8861\u76ee\u6807\u30023. \u6839\u636e\u60a3\u8005\u75c5\u60c5\u53d8\u5316\u53ca\u65f6\u8c03\u6574\u6cbb\u7597\u53c2\u6570\u4ee5\u8fbe\u5230\u6bcf\u5c0f\u65f6\u5bb9\u91cf\u5e73\u8861\u7684\u76ee\u6807\u30024. \u7ef4\u6301CRRT\u6ee4\u8fc7\u5206\u657025%\uff5e30%\uff0c\u6839\u636e\u60a3\u8005\u8840\u7ec6\u80de\u6bd4\u5bb9\u8c03\u8282\u7f6e\u6362\u6db2\u524d\u540e\u7a00\u91ca\u6bd4\u4f8b\uff0c\u51cf\u5c11\u6ee4\u5668\u4e2d\u8840\u6db2\u6d53\u7f29\u548c\u8840\u6db2\u86cb\u767d-\u819c\u53cd\u5e94\u3002<\/p>\n

\uff08\u4e8c\uff09 \u4e25\u91cd\u8113\u6bd2\u75c7\u5408\u5e76AKI\u60a3\u8005\u5bb9\u91cf\u7ba1\u7406\u7b56\u7565\u7684\u7406\u8bba\u57fa\u7840<\/h3>\n

Cordemans\u7b49\uff3b12\uff3d<\/sup>\u66fe\u63d0\u51fa\u8fc7\u201c\u4f11\u514b\u4e09\u6b21\u6253\u51fb\u7406\u8bba\u201d\u5b66\u8bf4\uff0c\u5373\u53d1\u75c56 h\u4ee5\u5185\uff0c\u673a\u4f53\u53d1\u751f\u5168\u8eab\u708e\u6027\u53cd\u5e94\u7efc\u5408\u5f81\u5bfc\u81f4\u5fae\u5faa\u73af\u969c\u788d\uff1b\u53d1\u75c524\uff5e72 h\uff0c\u5168\u8eab\u591a\u5668\u5b98\u529f\u80fd\u969c\u788d\u7efc\u5408\u5f81\uff1b\u53d1\u75c572 h\u540e\uff0c\u5982\u679c\u60a3\u8005\u4f11\u514b\u72b6\u6001\u672a\u5f97\u5230\u7ea0\u6b63\uff0c\u5bfc\u81f4\u5168\u8eab\u901a\u900f\u6027\u589e\u52a0\u7efc\u5408\u5f81\uff0c\u4e34\u5e8a\u591a\u8868\u73b0\u4e3a\u7ec4\u7ec7\u5668\u5b98\u4e25\u91cd\u6c34\u80bf\uff0c\u4e25\u91cd\u65f6\u4f1a\u53d1\u751f\u80ba\u6c34\u80bf\u3001\u8111\u6c34\u80bf\u3001\u6025\u6027\u547c\u5438\u7a98\u8feb\u7efc\u5408\u5f81\u6216\u6025\u6027\u80be\u5c0f\u7ba1\u574f\u6b7b\u7b49\u30021. \u5fae\u5faa\u73af\u969c\u788d\u671f\uff1a\u53d1\u75c56 h\u4ee5\u5185\uff0c\u901a\u8fc7\u6709\u521b\u76d1\u6d4b\u548c\u5e38\u89c4\u76d1\u6d4b\u6307\u6807\uff0c\u5982\u8840\u7ba1\u5916\u80ba\u6c34\u6307\u6570\u3001\u8840\u7ba1\u6e17\u6f0f\u6307\u6570\u3001\u5fc3\u8f93\u51fa\u91cf\uff08cardiac output\uff0cCO\uff09\u3001\u6bcf\u640f\u8f93\u51fa\u91cf\uff08stroke volume\uff0cSV\uff09\u3001\u8109\u640f\u538b\u53d8\u5f02\u5ea6\uff08pulse pressure variation\uff0cPPV\uff09\u3001CVP\u3001\u5e73\u5747\u52a8\u8109\u538b\uff08mean artery pressure\uff0cMAP\uff09\u3001\u4e2d\u5fc3\u9759\u8109\u8840\u6c27\u9971\u548c\u5ea6\uff08central venous oxygen saturation\uff0cSvc<\/sub>O2<\/sub>\uff09\u3001\u80ba\u52a8\u8109\u6954\u538b\uff08pulmonary artery wedge pressure\uff0cPAWP\uff09\u548c\u5c3f\u91cf\u7b49\u8bc4\u4f30\u60a3\u8005\u5bb9\u91cf\u72b6\u6001\u53ca\u5bb9\u91cf\u53cd\u5e94\u6027\u3002\u901a\u8fc7\u6db2\u4f53\u590d\u82cf\uff0c\u7ea0\u6b63\u60a3\u8005\u5bb9\u91cf\u5931\u8861\u72b6\u6001\uff0c\u4f7f\u8840\u6d41\u52a8\u529b\u5b66\u6307\u6807\u7a33\u5b9a\uff0c\u7ef4\u6301\u7ec4\u7ec7\u4f9b\u8840\u3001\u4f9b\u6c27\u3002\u8fd9\u4e00\u671f\u95f4CRRT\u5bb9\u91cf\u7ba1\u7406\u91c7\u7528\u6b63\u5e73\u8861\u76ee\u6807\uff0c\u7ea0\u6b63\u60a3\u8005\u5185\u73af\u5883\u7d0a\u4e71\uff0c\u6e05\u9664\u708e\u75c7\u4ecb\u8d28\u30022. \u591a\u5668\u5b98\u529f\u80fd\u969c\u788d\u671f\uff1a\u53d1\u75c524\uff5e72 h\uff0c\u91c7\u53d6\u9650\u5236\u6027\u6db2\u4f53\u6cbb\u7597\uff0c\u8fbe\u5230\u7ef4\u6301\u60a3\u8005\u5bb9\u91cf\u51fa\u5165\u5e73\u8861\uff0c\u4fdd\u8bc1\u60a3\u8005\u4f53\u91cd\u589e\u52a0\u4e0d\u8d85\u8fc7\u57fa\u7ebf\u768410%\u3002\u671f\u95f4CRRT\u5bb9\u91cf\u7ba1\u7406\u91c7\u7528\u96f6\u5e73\u8861\u76ee\u6807\uff0c\u7ef4\u6301\u60a3\u8005\u5185\u73af\u5883\u7a33\u5b9a\uff0c\u6e05\u9664\u708e\u75c7\u4ecb\u8d28\uff0c\u7ef4\u6301\u5bb9\u91cf\u5e73\u8861\u30023. \u7ec4\u7ec7\u5668\u5b98\u6c34\u80bf\u671f\uff1a\u53d1\u75c572 h\u540e\uff0c\u52a8\u6001\u8bc4\u4f30\u60a3\u8005\u5bb9\u91cf\u72b6\u6001\u53ca\u53cd\u5e94\u6027\uff0c\u9010\u6b65\u7ea0\u6b63\u60a3\u8005FO\u3002\u671f\u95f4CRRT\u5bb9\u91cf\u7ba1\u7406\u91c7\u7528\u8d1f\u5e73\u8861\u76ee\u6807\uff0c\u9010\u6b65\u6e05\u9664\u6db2\u4f53\uff0c\u7ef4\u6301\u8840\u6d41\u52a8\u529b\u5b66\u548c\u5185\u73af\u5883\u7a33\u5b9a\uff0c\u6e05\u9664\u708e\u75c7\u4ecb\u8d28\u3002\u76ee\u524d\u4e5f\u6709\u89c2\u70b9\u8ba4\u4e3a\u5408\u5e76AKI\u7684\u4e25\u91cd\u8113\u6bd2\u75c7\u60a3\u8005\u5bb9\u91cf\u7ba1\u7406\u53ef\u5206\u4e3a4\u4e2a\u9636\u6bb5\uff1a\u590d\u82cf\u9636\u6bb5\u3001\u4f18\u5316\u9636\u6bb5\u3001\u7a33\u5b9a\u9636\u6bb5\u548c\u964d\u9636\u68af\u9636\u6bb5\u3002\u672c\u5171\u8bc6\u4e13\u5bb6\u7ec4\u8ba4\u4e3a\uff0c\u4e0a\u8ff0\u4e24\u89c2\u70b9\u5747\u53ef\u6709\u6548\u6307\u5bfc\u4e34\u5e8a\uff0c\u4f46\u503c\u5f97\u6ce8\u610f\u7684\u662f\u6bcf\u4e2a\u9636\u6bb5CRRT\u5bb9\u91cf\u7ba1\u7406\u7b56\u7565\u5e94\u6839\u636e\u60a3\u8005\u75c5\u60c5\u8fdb\u884c\u4e2a\u6027\u5316\u5236\u5b9a\uff0c\u5b9e\u73b0\u6db2\u4f53\u548c\u6eb6\u8d28\u6e05\u9664\uff0c\u7ef4\u6301\u60a3\u8005\u8840\u6d41\u52a8\u529b\u5b66\u548c\u5185\u73af\u5883\u7a33\u5b9a\u3002<\/p>\n

\u4e94\u3001 AKI\u60a3\u8005\u5bb9\u91cf\u72b6\u6001\u53ca\u53cd\u5e94\u6027\u8bc4\u4f30<\/h2>\n

\u63a8\u8350\u610f\u89c1<\/p>\n

\u5efa\u8bae\u8054\u5408\u591a\u9879\u8bc4\u4f30\u65b9\u6cd5\u5e76\u52a8\u6001\u6d4b\u91cf\u91cd\u75c7AKI\u60a3\u8005\u5bb9\u91cf\u72b6\u6001\uff0c\u63d0\u9ad8\u5bb9\u91cf\u53cd\u5e94\u6027\u9884\u6d4b\u7684\u51c6\u786e\u5ea6\uff08\u2161B\uff09\u3002\u5bf9\u5bb9\u91cf\u53cd\u5e94\u6027\u8f83\u5dee\u7684AKI\u60a3\u8005\uff0c\u5efa\u8bae\u5236\u5b9a\u9002\u5f53\u7684\u5bb9\u91cf\u7ba1\u7406\u8ba1\u5212\uff08\u2161B\uff09\u3002\u5bf9\u8840\u6d41\u52a8\u529b\u5b66\u4e0d\u7a33\u5b9a\uff0c\u6db2\u4f53\u590d\u82cf\u540e\u4ecd\u4fdd\u6301\u8f83\u597d\u5bb9\u91cf\u53cd\u5e94\u6027\u7684AKI\u60a3\u8005\uff0c\u53ef\u8003\u8651\u4f7f\u7528\u8840\u7ba1\u6d3b\u6027\u836f\u7269\uff0c\u907f\u514dFO\u53d1\u751f\uff08\u2161B\uff09\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"

\u4e2d\u534e\u533b\u5b66\u4f1a\u80be\u810f\u75c5\u5b66\u5206\u4f1a\u4e13\u5bb6\u7ec4 \u901a\u4fe1\u4f5c\u8005\uff1a\u9648\u6c5f\u534e\uff0c\u6d59\u6c5f\u5927\u5b66\u533b\u5b66\u9662\u9644\u5c5e\u7b2c\u4e00\u533b\u9662\u80be\u810f\u75c5 … \u7ee7\u7eed\u9605\u8bfb →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[70],"tags":[],"class_list":["post-44512","post","type-post","status-publish","format-standard","hentry","category-70"],"_links":{"self":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/44512","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=44512"}],"version-history":[{"count":0,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/44512\/revisions"}],"wp:attachment":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=44512"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=44512"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=44512"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}