\u7f16\u8005\u6309<\/p>\n
\u529f\u80fd\u826f\u597d\u7684\u8840\u7ba1\u901a\u8def\u662f\u8fdb\u884c\u8840\u6db2\u900f\u6790\uff08HD\uff09\u6cbb\u7597\u7684\u5fc5\u5907\u6761\u4ef6\u3002\u968f\u7740\u7ec8\u672b\u671f\u80be\u810f\u75c5\uff08ESRD\uff09\u60a3\u8005\u9010\u6e10\u589e\u591a\u3001\u900f\u6790\u9f84\u5ef6\u957f\u4ee5\u53ca\u7cd6\u5c3f\u75c5\u3001\u9ad8\u8840\u538b\u7b49\u5408\u5e76\u75c7\u7684\u6bd4\u4f8b\u9010\u6e10\u589e\u52a0\uff0c\u8840\u7ba1\u901a\u8def\u7684\u5efa\u7acb\u3001\u4f7f\u7528\u548c\u7ef4\u62a4\u5df2\u7ecf\u6210\u4e3a\u4e0d\u5bb9\u5ffd\u89c6\u7684\u4e34\u5e8a\u95ee\u9898\uff0c\u80fd\u5426\u5efa\u7acb\u5e76\u7ef4\u62a4\u529f\u80fd\u826f\u597d\u7684\u8840\u7ba1\u901a\u8def\u5bf9\u7ec8\u672b\u671f\u80be\u810f\u75c5\u60a3\u8005\u7684\u9884\u540e\u81f3\u5173\u91cd\u8981\u3002\u4eba\u5de5\u667a\u80fd\u7b49\u65b0\u6280\u672f\u7684\u53d1\u5c55\u4e5f\u5728\u6539\u5584\u8840\u900f\u8840\u7ba1\u901a\u8def\u7ba1\u7406\u65b9\u9762\u8d77\u5230\u91cd\u8981\u4f5c\u7528\u3002\u5728\u8fd1\u671f\u7684\u5b66\u672f\u4f1a\u8bae\u4e0a\uff0c\u56db\u5ddd\u5927\u5b66\u534e\u897f\u533b\u9662\u80be\u810f\u5185\u79d1\u4f59\u5c11\u658c\u526f\u4e3b\u4efb\u533b\u5e08\u5206\u4eab\u4e86\u8840\u6db2\u900f\u6790\u8840\u7ba1\u901a\u8def\u7ba1\u7406\u53ca\u8fdb\u5c55\u3002<\/p>\n
HD\u60a3\u8005\u8840\u7ba1\u901a\u8def\u7684\u5efa\u7acb<\/p>\n
2020\u5e74\uff0c\u201c\u80be\u810f\u75c5\u9884\u540e\u8d28\u91cf\u5021\u8bae\uff08KDOQI\uff09\u201d\u53d1\u5e03\u4e86\u8840\u7ba1\u901a\u8def\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u76842019\u5e74\u66f4\u65b0\u3002\u4e0e\u65e7\u6307\u5357\u63a8\u8350\u7684\u201c\u5185\u7618\u4f18\u5148\uff08fistula first\uff09\u201d\u539f\u5219\u4e0d\u540c\uff0c\u65b0\u6307\u5357\u7740\u91cd\u5f3a\u8c03\u6839\u636e\u201c\u60a3\u8005\u4f18\u5148\uff08patient first\uff09\u201d\u539f\u5219\u9009\u62e9\u8840\u7ba1\u901a\u8def\uff0c\u5e76\u63d0\u51fa\u4e86\u201c\u7ec8\u672b\u671f\u80be\u810f\u75c5\u751f\u5b58\u8ba1\u5212\u201d\u7684\u6982\u5ff5\u3002<\/p>\n
\u201c\u7ec8\u672b\u671f\u80be\u810f\u75c5\u751f\u5b58\u8ba1\u5212\u201d\u662f\u4e00\u79cd\u5f3a\u8c03\u4e0e\u7ec8\u672b\u671f\u80be\u810f\u75c5\u5171\u5b58\u7684\u7ba1\u7406\u6a21\u5f0f\uff0c\u65e8\u5728\u4ee5ESRD\u60a3\u8005\u4e3a\u4e2d\u5fc3\uff0c\u7531\u60a3\u8005\u548c\u6162\u6027\u80be\u810f\u75c5\uff08CKD\uff09\u7ba1\u7406\u56e2\u961f\uff08\u5305\u62ec\u80be\u810f\u75c5\u533b\u751f\u3001\u5916\u79d1\u533b\u751f\u3001\u4ecb\u5165\u79d1\u533b\u751f\u3001\u62a4\u58eb\u3001\u60a3\u8005\u5bb6\u5ead\u7b49\uff09\u5171\u540c\u53c2\u4e0e\uff0c\u5145\u5206\u8003\u8651\u60a3\u8005\u7684\u9884\u671f\u5bff\u547d\u3001\u533b\u7597\u72b6\u6001\u3001\u751f\u6d3b\u76ee\u6807\u3001\u4e2a\u4eba\u504f\u597d\u3001\u793e\u4f1a\u652f\u6301\u7b49\u591a\u65b9\u9762\u56e0\u7d20\uff0c\u5236\u5b9a\u6709\u9488\u5bf9\u6027\u7684\u80be\u810f\u75c5\u7ba1\u7406\u7b56\u7565\uff0c\u4ece\u800c\u6700\u5927\u7a0b\u5ea6\u5730\u6539\u5584ESRD\u60a3\u8005\u7684\u4e2a\u4f53\u9884\u540e\u3002<\/p>\n
\u6839\u636e\u201c\u60a3\u8005\u4f18\u5148\u201d\u539f\u5219\uff0c\u8840\u7ba1\u901a\u8def\u7684\u9009\u62e9\u5e94\u7eb3\u5165\u201c\u7ec8\u672b\u671f\u80be\u810f\u75c5\u751f\u5b58\u8ba1\u5212\u201d\u7efc\u5408\u8003\u8651\uff0c\u5305\u542b\u60a3\u8005\u3001\u751f\u5b58\u8ba1\u5212\u3001\u901a\u8def\u3001\u9700\u6c42\u7b494\u4e2a\u7ef4\u5ea6\uff08patients-life plan-access-needs\uff0cP-L-A-N\uff09\u3002\u5728\u9009\u62e9\u8840\u7ba1\u901a\u8def\u65f6\uff0c\u4e0d\u4ec5\u5e94\u5145\u5206\u8bc4\u4f30\u60a3\u8005\u7684\u5f53\u524d\u72b6\u6001\uff0c\u8fd8\u5e94\u8be5\u5bf9\u53ef\u9884\u671f\u7684\u4e0d\u826f\u4e8b\u4ef6\uff08\u4f8b\u5982\u53ef\u9884\u6d4b\u7684\u8840\u7ba1\u901a\u8def\u5e76\u53d1\u75c7\uff09\u5236\u5b9a\u8865\u6551\u8ba1\u5212\uff0c\u5e76\u5145\u5206\u8003\u8651\u60a3\u8005\u672a\u6765\u7684\u901a\u8def\u9009\u62e9\u3002<\/p>\n
HD\u60a3\u8005\u8840\u7ba1\u901a\u8def\u7684\u7ef4\u62a4\u672f\u524d\u8fd0\u52a8\u4fc3\u4f7f\u52a8\u9759\u8109\u76f4\u5f84\u548c\u6d41\u901f\u589e\u9ad8<\/p>\n
\u7814\u7a76\u663e\u793a\uff0c\u624b\u672f\u524d\u4e3a\u671f8\u5468\u7684\u624b\u63e1\u88c5\u7f6e\u548c\u677e\u7d27\u5e26\u7ec4\u5408\u7b49\u8ddd\u8fd0\u52a8\u53ef\u4f7f\u52a8\u9759\u8109\u76f4\u5f84\u3001\u52a8\u8109\u6536\u7f29\u671f\u5cf0\u503c\u901f\u5ea6\u4ee5\u53ca\u624b\u81c2\u6700\u5f3a\u529b\u5ea6\u663e\u8457\u589e\u9ad8\uff0c\u5176\u673a\u5236\u53ef\u80fd\u4e0e\u4e00\u6c27\u5316\u6c2e\u3001\u4e0d\u5bf9\u79f0\u4e8c\u7532\u57fa\u7684\u751f\u6210\u6709\u5173[2]<\/sup>\u3002<\/p>\n AVF\u5185\u7618\u4fa7\u4e0a\u80a2\u529f\u80fd\u969c\u788d<\/p>\n \u7814\u7a76\u8868\u660e\uff0c\u8840\u6db2\u900f\u6790\uff08HD\uff09\u60a3\u8005\u5185\u7618\u4fa7\u80a2\u4f53\u4e0e\u975e\u5185\u7618\u4fa7\u80a2\u4f53\u76f8\u6bd4\uff0c\u5b58\u5728\u63e1\u529b\u4e0b\u964d\u548c\u88ab\u52a8\u638c\u66f2\u529f\u80fd\u5f02\u5e38\uff0c\u9700\u8981\u5f15\u8d77\u4e34\u5e8a\u533b\u5e08\u7684\u9ad8\u5ea6\u5173\u6ce8\uff0c\u5c3d\u65e9\u5f00\u5c55\u5185\u7618\u4fa7\u624b\u90e8\u7684\u6293\u63e1\u8fd0\u52a8\u53ca\u8155\u5173\u8282\u7684\u638c\u66f2\u3001\u80cc\u4f38\u3001\u65cb\u8f6c\u6d3b\u52a8\uff0c\u4ee5\u671f\u63d0\u9ad8\u60a3\u8005\u7684\u751f\u6d3b\u8d28\u91cf\u548c\u5de5\u4f5c\u80fd\u529b[1]<\/sup>\u3002<\/p>\n<\/p>\n \u56fe1. \u4e0a\u80a2\u8fd0\u52a8\u4fc3\u8fdb\u5185\u7618\u6210\u719f\u3002(a)\u6a61\u80f6\u7403\u52a0\u538b\uff0c(b)\u638c\u95f4\u52a0\u538b\uff0c(c)\u6307\u538b\u94b3\u52a0\u538b\uff0c(d)\u5185\u6536\u5916\u5c55\uff0c(e)\u4fef\u5367\u65cb\u540e\uff0c(f)\u538b\u529b\uff0c(g)\u91cd\u91cf\u4e3a1kg\u7684\u5c48\u4f38\uff0c(h)\u538b\u529b\u94b3\u548c(i)\u6307\u95f4\u538b\u529b<\/p>\n \u624b\u90e8\u8fd0\u52a8\u4fc3\u8fdb\u5185\u7618\u5934\u9759\u8109\u6210\u719f<\/p>\n \u4e00\u9879RCT\u7814\u7a76\u6bd4\u8f83\u7b49\u957f\u624b\u90e8\u8fd0\u52a8\uff08\u4ee5\u589e\u52a0\u808c\u8089\u5f20\u529b\u6765\u5bf9\u6297\u4e00\u4e2a\u56fa\u5b9a\u7684\u963b\u529b\u7684\u8fd0\u52a8\uff09\u4e0e\u7b49\u5f20\u624b\u90e8\u8fd0\u52a8\uff08\u808c\u8089\u6536\u7f29\u65f6\u808c\u7ea4\u7ef4\u7f29\u77ed\uff0c\u800c\u4f5c\u7528\u5728\u808c\u8089\u4e0a\u7684\u8d1f\u8377\u4e0d\u53d8\uff0c\u8fd0\u52a8\u8fc7\u7a0b\u4e2d\u808c\u8089\u5f20\u529b\u4e0d\u53d1\u751f\u660e\u663e\u53d8\u5316\uff09\u5bf9\u5185\u7618\u6210\u719f\u7684\u5f71\u54cd\uff0c\u7ed3\u679c\u53d1\u73b0\u7b49\u957f\u624b\u90e8\u8fd0\u52a8\u66f4\u80fd\u4fc3\u8fdb\u5185\u7618\u5934\u9759\u8109\u6210\u719f\u3002\u4e24\u79cd\u8fd0\u52a8\u65b9\u5f0f\u5bf9\u5185\u7618\u5efa\u7acb\u90fd\u662f\u6709\u6548\u7684\u3002<\/p>\n \u672f\u540e\u8fd0\u52a8\u4fc3\u4f7f\u5934\u9759\u8109\u8840\u6d41\u91cf\u589e\u52a0<\/p>\n \u7814\u7a76\u663e\u793a\uff0c\u624b\u672f\u540e\uff0c\u4e0e\u6324\u538b\u6a61\u76ae\u7403\u7684\u5bf9\u7167\u7ec4\u76f8\u6bd4\uff0c\u5728\u975e\u900f\u6790\u65e5\u4e3e6\u78c5\uff082.7Kg\uff09\u91cd\u7684\u54d1\u94c33\u4e2a\u6708\u540e\uff0c\u8bd5\u9a8c\u7ec4\u5934\u9759\u8109\u8840\u6d41\u91cf\u663e\u8457\u589e\u52a0[3]<\/sup>\u3002<\/p>\n<\/p>\n \u56fe2. \u54d1\u94c3\u8fd0\u52a8<\/p>\n \u672f\u540e\u53ef\u9002\u91cf\u4e3e\u91cd<\/p>\n \u60a3\u8005\u53ef\u5b89\u5168\u5730\u4f7f\u7528\u9020\u7618\u4fa7\u624b\u81c2\u4e3e\u8d77\u91cd\u91cf\u5c0f\u4e8e6\u78c5\uff082.7Kg\uff09\u7684\u7269\u4f53\uff0c\u5728\u4fc3\u8fdbAVF\u6210\u719f\u7684\u540c\u65f6\u4fdd\u7559\u5176\u624b\u81c2\u529f\u80fd[4]<\/sup>\u3002<\/p>\n \u4e2a\u6027\u5316\u7b49\u8ddd\u8bad\u7ec3<\/p>\n 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\u624b\u672f\u540e\u8fd0\u52a8\u8bad\u7ec3\u53ef\u6539\u5584AVF\u7684\u4e34\u5e8a\u6210\u719f\u5ea6\u548c\u8840\u6d41\u52a8\u529b\u5b66\u3002\u7814\u7a76\u663e\u793a\uff0c\u65e0\u521b\u63e1\u624b\u8fd0\u52a8\u53ef\u589e\u52a0\u524d\u81c2\u8fdc\u7aef\u5934\u9759\u8109\u76f4\u5f84\uff0c\u4ece\u800c\u589e\u52a0AVF\u6210\u529f\u7387[6]<\/sup>\u3002<\/p>\n \u56fe4. \u63e1\u624b\u8fd0\u52a8\u672f\u540e\u624b\u81c2\u6b62\u8840\u5e26\u624b\u90e8\u8fd0\u52a8<\/p>\n \u4f7f\u7528\u624b\u81c2\u6b62\u8840\u5e26\u8fdb\u884c\u624b\u90e8\u8fd0\u52a8\uff0c\u80fd\u589e\u52a0\u5f15\u6d41\u9759\u8109\u76f4\u5f84\u3001\u9759\u8109\u58c1\u539a\u5ea6\u3001\u9759\u8109\u9762\u79ef\u548c\u8840\u6d41\u901f\u7387\uff0c\u6709\u52a9\u4e8e\u52a0\u901fAVF\u4e34\u5e8a\u6210\u719f[7]<\/sup>\u3002<\/p>\n<\/p>\n \u56fe5. \u672f\u540e\u624b\u81c2\u6b62\u8840\u5e26\u624b\u90e8\u8fd0\u52a8<\/p>\n \u5bb6\u5ead\u8fd0\u52a8\u8bad\u7ec3\u63d0\u5347\u624b\u81c2\u548c\u817f\u90e8\u808c\u8089\u529b\u91cf<\/p>\n \u7814\u7a76\u663e\u793a\uff0c\u624b\u672f\u524d\u540e\u7684\u5bb6\u5ead\u8fd0\u52a8\u8bad\u7ec3\u53ef\u63d0\u5347ESRD\u60a3\u8005\u624b\u81c2\u548c\u817f\u90e8\u808c\u8089\u529b\u91cf[8]<\/sup>\u3002<\/p>\n \u8840\u7ba1\u901a\u8def\u7684\u76d1\u5bdf\u4e0e\u76d1\u6d4b\u5e76\u53d1\u75c7\u8bca\u65ad\u2014\u2014\u5185\u7618\u6210\u719f\u4e0d\u826f<\/p>\n \u4fa7\u652f\u5224\u65ad\uff1a\u624b\u6307\u538b\u95ed\u5185\u7618\u7618\u4f53\u4e0a\u4efb\u610f1\u70b9\uff0c\u53e6\u4e00\u624b\u611f\u89c9\u543b\u5408\u53e3\u9707\u98a4\u60c5\u51b5\u3002\u5982\u9707\u98a4\u6d88\u5931\uff0c\u8868\u660e\u538b\u95ed\u70b9\u7684\u8fdc\u5fc3\u7aef\u65e0\u8f83\u7c97\u5927\u7684\u4fa7\u652f\u5f62\u6210\uff1b\u9707\u98a4\u5b58\u5728\u6216\u51cf\u5f31\uff0c\u8868\u660e\u538b\u95ed\u70b9\u8fdc\u5fc3\u7aef\u6709\u8f83\u7c97\u5927\u4fa7\u652f\u3002<\/p>\n<\/p>\n \u56fe6. \u4fa7\u652f\u5224\u65ad<\/p>\n \u5e76\u53d1\u75c7\u8bca\u65ad\u2014\u2014\u72ed\u7a84<\/p>\n \u72ed\u7a84\u5206\u7c7b<\/p>\n \u72ed\u7a84\u53ef\u5206\u4e3a\u4ee5\u4e0b4\u7c7b\uff1a<\/p>\n \u25a0 I\u578b\u72ed\u7a84\uff1a\u52a8\u9759\u8109\u543b\u5408\u53e3\u53ca\u8ddd\u543b\u5408\u53e32cm\u5185\u7684\u9759\u8109\u8840\u7ba1\u3002<\/p>\n \u25a0 II\u578b\u72ed\u7a84\uff1a\u52a8\u9759\u8109\u5185\u7618\u8840\u7ba1\u7a7f\u523a\u90e8\u4f4d\u3002<\/p>\n \u25a0 III\u578b\u72ed\u7a84\uff1a\u52a8\u9759\u8109\u5185\u7618\u76f8\u5173\u9759\u8109\u6c47\u5165\u6df1\u9759\u8109\u5904\u72ed\u7a84\uff0c\u5982\u4e0a\u81c2\u5934\u9759\u8109\u6c47\u5165\u814b\u9759\uff0c\u9501\u9aa8\u4e0b\u9759\u8109\u6c47\u5165\u65e0\u540d\u9759\u8109\u5904\u548c\u65e0\u660e\u9759\u8109\u9759\u8109\u6c47\u5165\u4e0a\u8154\u9759\u8109\u5904\u3002<\/p>\n \u25a0 IV\u578b\u72ed\u7a84\uff1a\u4f9b\u7ed9\u52a8\u9759\u8109\u5185\u7618\u8840\u6d41\u7684\u52a8\u8109\u72ed\u7a84\uff0c\u8840\u6d41\u91cf\u4e0d\u8db3\u2264180ml\/min\u548c\u6cf5\u524d\u8d1f\u538b\u5347\u9ad8\uff0c\u800c\u52a8\u9759\u8109\u543b\u5408\u53e3\u65e0\u660e\u663e\u72ed\u7a84\u3002<\/p>\n \u5185\u7618\u72ed\u7a841<\/p>\n \u89c6\u8bca\uff1a\u8868\u73b0\u4e3a\u5c40\u90e8\u8840\u7ba1\u7f29\u7a84\uff0c\u72ed\u7a84\u8fd1\u5fc3\u7aef\u9759\u8109\u65e0\u6269\u5f20\uff0c\u751a\u81f3\u8840\u7ba1\u584c\u9677\uff0c\u8fdc\u5fc3\u7aef\u53ef\u6709\u8f7b\u5ea6\u6269\u5f20\u3002<\/p>\n \u542c\u8bca\uff1a\u51fa\u73b0\u9ad8\u8c03\u97f3\uff0c\u6027\u8d28\u4e3a\u975e\u8fde\u7eed\u6027\u7684\u6536\u7f29\u671f\u6742\u97f3\uff0c\u8212\u5f20\u671f\u6742\u97f3\u51cf\u5f31\u6216\u6d88\u5931\u3002<\/p>\n<\/p>\n \u56fe7. \u5185\u7618\u72ed\u7a841\u7684\u8bca\u65ad<\/p>\n \u5185\u7618\u72ed\u7a842<\/p>\n \u640f\u52a8\u589e\u5f3a\u8bd5\u9a8c\u9633\u6027\uff1a\u65e0\u640f\u52a8\u589e\u5f3a\uff0c\u4f9b\u8840\u52a8\u8109\u8840\u6d41\u91cf\u4e0d\u8db3\u3002<\/p>\n \u4e3e\u81c2\u8bd5\u9a8c\u5f02\u5e38\uff1a\u8840\u6db2\u56de\u6d41\u4e0d\u7545\uff0c\u5c40\u90e8\u8840\u7ba1\u5f20\u529b\u589e\u52a0\uff0c\u4e0d\u80fd\u584c\u9677\uff0c\u5f02\u5e38\u5904\u5b58\u5728\u72ed\u7a84\u3002<\/p>\n<\/p>\n \u56fe8. \u640f\u52a8\u589e\u5f3a\u8bd5\u9a8c<\/p>\n<\/p>\n \u56fe9. \u4e3e\u81c2\u8bd5\u9a8c\u5e76\u53d1\u75c7\u8bca\u65ad\u2014\u2014\u5185\u7618\u72ed\u7a843<\/p>\n 1<\/p>\n \u4f9b\u8840\u52a8\u8109\u72ed\u7a84\uff1a\u543b\u5408\u53e3\u9707\u98a4\u3001\u640f\u52a8\u51cf\u5f31\u3002<\/p>\n 2<\/p>\n \u543b\u5408\u53e3\u8fd1\u7aef\u53ca\u7618\u4f53\u72ed\u7a84\uff1a\u72ed\u7a84\u5904\u9707\u98a4\u589e\u5f3a\uff0c\u6536\u7f29\u671f\u975e\u8fde\u7eed\u6027\u9707\u98a4\uff0c\u5982\u9707\u98a4\u5b8c\u5168\u6d88\u5931\uff0c\u5185\u7618\u53d1\u751f\u95ed\u585e\u3002<\/p>\n 3<\/p>\n \u543b\u5408\u53e3\u72ed\u7a84\uff1a\u7618\u4f53\u640f\u52a8\u51cf\u5f31\u3002<\/p>\n 4<\/p>\n \u543b\u5408\u53e3\u8fd1\u5fc3\u7aef\u9759\u8109\u3001\u7618\u4f53\u53ca\u6d41\u51fa\u6bb5\u72ed\u7a84\uff1a\u72ed\u7a84\u5904\u8fdc\u5fc3\u7aef\u640f\u52a8\u589e\u5f3a\u6216\u51fa\u73b0\u6c34\u51b2\u8109\u3002<\/p>\n<\/p>\n \u56fe10. \u5185\u7618\u72ed\u7a843\u7684\u8bca\u65ad<\/p>\n \u4e34\u5e8a\u5224\u65ad\u63d0\u793a<\/p>\n \u25a0 \u9707\u98a4\u51cf\u5f31\u4f46\u8109\u640f\u589e\u5f3a\uff1a\u8fd1\u7aef\u9759\u8109\u72ed\u7a84\u3002<\/p>\n \u25a0 \u9707\u98a4\u3001\u8109\u640f\u3001\u6742\u97f3\u5747\u6d88\u5931\uff1a\u543b\u5408\u53e3\u72ed\u7a84\u3002<\/p>\n \u25a0 \u9707\u98a4\u3001\u8109\u640f\u5747\u8f83\u5f31\uff0c\u9759\u8109\u65e0\u660e\u663e\u5145\u76c8\uff1a\u52a8\u8109\u72ed\u7a84\u3002<\/p>\n \u25a0 \u89e6\u8bca\u52a8\u9759\u8109\u5185\u7618\u8840\u7ba1\u53d8\u786c\u3001\u53d8\u7ec6\u3001\u7a7f\u523a\u56f0\u96be\uff1a\u5185\u7618\u8840\u6813\u6216\u5185\u7618\u95ed\u585e\u3002<\/p>\n \u25a0 AVG:<\/p>\n \u52a8\u8109\u6bb5\u3001\u79fb\u690d\u7269\u4e2d\u6bb5\u3001\u9759\u8109\u6bb5\u5747\u80fd\u89e6\u53ca\u6b63\u5e38\u9707\u98a4\uff1a\u5185\u7618\u8840\u6d41\u91cf\uff1e450ml\/min\uff1b<\/p>\n \u814b\u4e0b\u80fd\u89e6\u53ca\u9707\u98a4\uff1a\u8840\u6d41\u91cf\uff1e500ml\/min\u3002\u5229\u7528\u8109\u51b2\u96f7\u8fbe\u4f20\u611f\u5668\u548c\u673a\u5668\u5b66\u4e60\u5206\u7c7b\u8fdb\u884c\u65e9\u671f\u68c0\u6d4b<\/p>\n \u4e00\u79cd\u7531\u8109\u51b2\u96f7\u8fbe\u4f20\u611f\u5668\u548c\u652f\u6301\u5411\u91cf\u673a\u5206\u7c7b\u7b97\u6cd5(SVM)\u7ec4\u6210\u7684\u65e0\u521b\u8840\u7ba1\u58c1\u8fd0\u52a8\uff08VWM\uff09\u76d1\u6d4b\u7cfb\u7edf\uff0c\u7528\u4e8e\u68c0\u6d4bAVF\u7684\u901a\u8def\u8840\u6d41\u529f\u80fd\u969c\u788d\u3002\u7ed3\u679c\u8868\u660e\uff0c\u4e0e\u8d85\u58f0\u7a00\u91ca\u6d41\u91cf\u76d1\u6d4b\u5668\u76f8\u6bd4\uff0cVWM\u76d1\u6d4b\u5668\u53ef\u4ee5\u5b9e\u73b0\u5bf9AVF\u6d41\u91cf\u529f\u80fd\u969c\u788d\u7684\u66f4\u51c6\u786e\u9884\u6d4b\u3002ROC\u66f2\u7ebf\u5206\u6790\u8868\u660e\uff0c\u5728500\u81f3750 ml\/min\u7684\u8840\u6d41\u91cf\u8303\u56f4\u5185\uff0cSVM\u5206\u7c7b\u7b97\u6cd5\u7684\u68c0\u6d4b\u7279\u5f02\u6027\u4e3a100%\uff0c\u5728750ml\/min\u7684\u6d41\u91cf\u8303\u56f4\uff0c\u68c0\u6d4b\u7075\u654f\u5ea6\u6700\u9ad8\uff0c\u4e3a95.2%[9]<\/sup>\u3002<\/p>\n \u56fe11. VWM\u76d1\u6d4b\u4eea\u7684\u7cfb\u7edf\u56fe\u548c\u6d4b\u91cfAVF\u8840\u7ba1\u58c1\u8fd0\u52a8\u7684\u539f\u7406\u3002\uff08A\uff09\u8109\u51b2\u96f7\u8fbe\u4f20\u611f\u5668\u68c0\u6d4b\u8840\u6d41\u7684\u793a\u610f\u56fe\uff08B\uff09\u8109\u51b2\u591a\u666e\u52d2\u96f7\u8fbe\u53d1\u5c04\u548c\u63a5\u6536\u6ce2\uff08C\uff09\u4fe1\u53f7\u7684\u793a\u610f\u56fe\u4eba\u5de5\u667a\u80fd\u6a21\u578b\u81ea\u52a8\u68c0\u6d4b\u52a8\u9759\u8109\u7618\u72ed\u7a84<\/p>\n \u4eba\u5de5\u667a\u80fd\uff08AI\uff09\u6a21\u578b\u4f7f\u7528\u5ec9\u4ef7\u4e14\u65e0\u521b\u7684\u97f3\u9891\u8bb0\u5f55\u6765\u68c0\u6d4bAVF\u72ed\u7a84\u3002\u6a21\u578b\u57fa\u4e8e\u77ed\u65f6\u5085\u7acb\u53f6\u53d8\u6362\uff08STFT\uff09\u548c\u6837\u672c\u71b5\u7684\u4e24\u4e2a\u65b0\u8f93\u5165\u7279\u5f81\u4ee5\u53ca\u4e24\u4e2a\u76f8\u5173\u5206\u7c7b\u6a21\u578b\uff08ResNet50\u548cANN\uff09\u7684\u7ec4\u5408\uff0c\u5728\u68c0\u6d4b\u5230\u5927\u4e8e50%\u7684\u72ed\u7a84\u65f6\u7279\u5f02\u6027\u8d85\u8fc790%[10]<\/sup>\u3002<\/p>\n<\/p>\n \u56fe12. \u4eba\u5de5\u667a\u80fd\u6a21\u578b\u81ea\u52a8\u68c0\u6d4b\u52a8\u9759\u8109\u7618\u72ed\u7a84\u6df1\u5ea6\u5b66\u4e60\u8bc4\u4ef7\u8840\u6db2\u900f\u6790\u52a8\u9759\u8109\u5185\u7618\u72ed\u7a84<\/p>\n \u4e00\u9879\u7814\u7a76\u901a\u8fc7\u52a8\u9759\u8109\u7618\u7684\u58f0\u97f3\uff0c\u4f7f\u7528\u6df1\u5ea6\u5b66\u4e60\u65b9\u6cd5\u8bc4\u4f30\u58f0\u97f3\uff0c\u6765\u8865\u5145\u8840\u6db2\u900f\u6790\u60a3\u8005\u7684\u65e5\u5e38\u52a8\u9759\u8109\u7618\u68c0\u67e5[11]<\/sup>\u3002\u8be5\u9879\u7814\u7a76\u7eb3\u516520\u540d\u60a3\u8005\uff0c\u57281\u5206\u949f\u5185\u8bb0\u5f55\u52a8\u9759\u8109\u7618\u542c\u8bca\u58f0\u97f3\uff08192kHz\uff0c24\u4f4d\uff09\u8fdb\u884c\u91c7\u6837\u3002\u901a\u8fc7\u4f7f\u7528\u5377\u79ef\u795e\u7ecf\u7f51\u7edc\uff08CNN\uff09\u6a21\u578b\u4e3a\u6bcf\u4e2a\u6ca1\u6709\u73af\u5883\u58f0\u97f3\u7684\u5fc3\u8df3\u63d0\u53d6\u52a8\u9759\u8109\u7618\u58f0\u97f3\uff0c\u5e76\u4f7f\u7528\u5177\u6709\u53cc\u5411\u957f\u77ed\u671f\u8bb0\u5fc6\u7684CNN\u5b66\u4e60\u6a21\u578b\u8fdb\u884c\u8bc4\u5206\uff0c\u5176\u4e2d\u52a8\u9759\u8109\u7618\u72ed\u7a84\u7a0b\u5ea6\u88ab\u5206\u4e3a\u4e94\u79cd\u58f0\u97f3\u7c7b\u578b\u4e4b\u4e00\uff08\u5373\u6b63\u5e38\u3001\u575a\u786c\u3001\u9ad8\u3001\u95f4\u6b47\u6027\u548c\u53e3\u54e8\u58f0\uff09\u3002\u7ecf\u8fc7100\u4e2a\u8bad\u7ec3\u65f6\u671f\u540e\uff0c\u8be5\u65b9\u6cd5\u51c6\u786e\u738770-93%\u3002ROC\u66f2\u7ebf\u4e0b\u9762\u79ef\uff08AUC\uff09\u4e3a0.75-0.92\u3002<\/p>\n<\/p>\n \u56fe13. \u6df1\u5ea6\u5b66\u4e60\u8bc4\u4ef7\u8840\u6db2\u900f\u6790\u52a8\u9759\u8109\u5185\u7618\u72ed\u7a84\u4f7f\u7528\u65b0\u578b\u5149\u7535\u5bb9\u79ef\u8109\u640f\u6ce2\u4f20\u611f\u5668\u8bbe\u5907\u8bc4\u4f30AVF\u72ed\u7a84\u7a0b\u5ea6\u548c\u8840\u6d41\u91cf\u7684\u673a\u5668\u5b66\u4e60\u5206\u7c7b\u6cd5<\/p>\n \u4e00\u9879\u7814\u7a76\u4f7f\u7528\u65b0\u578b\u5149\u7535\u5bb9\u79ef\u8109\u640f\u6ce2\uff08PPG\uff09\u4f20\u611f\u5668\u8bbe\u5907\u8bc4\u4f30HD\u60a3\u8005AVF\u529f\u80fd\u7684\u652f\u6301\u5411\u91cf\u673a\uff08SVM\uff09\u5b66\u4e60\u5206\u7c7b\u5668\u3002\u8bc4\u4f30AVF\u529f\u80fd\u67092\u4e2a\u91cd\u8981\u6307\u6807\uff1a\u8840\u6d41\u91cf\uff08BFV\uff09\u548c\u72ed\u7a84\u7a0b\u5ea6\uff08DOS\uff09\u3002\u7814\u7a76\u5229\u7528\u65b0\u5f00\u53d1\u7684PPG\u4f20\u611f\u5668\u8bbe\u5907\uff0c\u901a\u8fc7\u6700\u5927\u5316\u6210\u529f\u8fdb\u5165\u6a21\u6570\u8f6c\u6362\u5668\uff08ADC\uff09\u7684\u6d4b\u91cfPPG\u7684\u5168\u52a8\u6001\u8303\u56f4\u548c\u6709\u6548\u7684\u6ee4\u6ce2\u6280\u672f\uff0c\u6765\u63d0\u9ad8\u4fe1\u566a\u6bd4\uff08SNR\uff09\u5e76\u51cf\u5c11\u73af\u5883\u5e72\u6270\u3002\u7ed3\u679c\u8868\u660ePPG\u4f20\u611f\u5668\u8bbe\u5907\u8bc4\u4f30DOS\u7684\u51c6\u786e\u7387\u8fbe87.84%\uff0c\u8bc4\u4f30BFV\u51c6\u786e\u7387\u8fbe88.61%\u3002<\/p>\n<\/p>\n \u56fe14. \u4f20\u611f\u5668\u8bbe\u5907\u8bc4\u4f30AVF\u72ed\u7a84\u7a0b\u5ea6\u548c\u8840\u6d41\u91cf\u7684\u673a\u5668\u5b66\u4e60\u5206\u7c7b\u6cd5\u672a\u6765\u5c55\u671b\u5fae\u521b\u8bca\u7597\u65b0\u6280\u672f<\/p>\n \u672a\u6765\uff0c\u6211\u4eec\u5c06\u4ece\u4ee5\u4e0b\u65b9\u9762\u6253\u9020\u900f\u6790\u901a\u8def\u4f18\u52bf\u8bca\u7597\u6280\u672f\uff0c\u62d3\u5c55\u5fae\u521b\u8bca\u7597\u65b0\u6280\u672f\uff1a<\/p>\n 1<\/p>\n \u7ec6\u5316\u5f71\u50cf\u5b66\u6280\u672f\u8bc4\u4f30\u4e2d\u5fc3\u9759\u8109\u75be\u75c5\u7684\u4e34\u5e8a\u5e94\u7528\u7814\u7a76\u3002<\/p>\n 2<\/p>\n \u4ece\u900f\u6790\u901a\u8def\u65e9\u671f\u5efa\u7acb\u4e0e\u7ef4\u62a4\u3001\u8840\u7ba1\u8017\u7aed\u7b49\u591a\u89d2\u5ea6\u5165\u624b\uff0c\u8bc4\u4ef7\u5fae\u521b\u8bca\u7597\u6280\u672f\u7684\u4e34\u5e8a\u5e94\u7528\u4ef7\u503c\u3002<\/p>\n 3<\/p>\n \u79ef\u6781\u62d3\u5c55\u900f\u6790\u901a\u8def\u7b49\u591a\u9879\u8bca\u7597\u65b0\u6280\u672f\u3001\u65b0\u5668\u68b0\u5728\u56fd\u5185\u7387\u5148\u5e94\u7528<\/p>\n \u591a\u5b66\u79d1\u534f\u4f5c\u56e2\u961f<\/p>\n \u672a\u6765\uff0c\u6211\u4eec\u5c06\u4ece\u4ee5\u4e0b\u65b9\u9762\uff0c\u6784\u5efa\u900f\u6790\u901a\u8def\u4e13\u4e1a\u4eba\u624d\u68af\u961f\uff0c\u805a\u7126\u591a\u5b66\u79d1\u534f\u4f5c\u56e2\u961f\uff1a<\/p>\n 1<\/p>\n \u5408\u7406\u914d\u7f6e\u901a\u8def\u4e9a\u4e13\u4e1a\u201c\u8001\u4e2d\u9752\u201d\u4e34\u5e8a\u533b\u5e08\u56e2\u961f\u3002<\/p>\n 2<\/p>\n \u7ec4\u5efa\u4ee5\u4e34\u5e8a\u4e3a\u6838\u5fc3\uff0c\u5faa\u8bc1\u533b\u5b66\u4e0e\u57fa\u7840\u533b\u5b66\u7b49\u591a\u9886\u57df\u4e13\u4e1a\u4eba\u624d\u7d27\u5bc6\u914d\u5408\u7684\u4e00\u4f53\u5316\u79d1\u7814\u5c0f\u7ec4\u3002<\/p>\n 3<\/p>\n \u56fd\u5185\u5916\u4e0e\u56fd\u9645\u5b66\u672f\u4ea4\u6d41\uff0c\u57f9\u80b2\u56fd\u5185\u77e5\u540d\u7684\u5b66\u672f\u5e26\u5934\u4eba\u4e0e\u9752\u5e74\u9886\u519b\u4eba\u624d\u3002<\/p>\n \u5c0f \u7ed3L<\/p>\n \u8840\u7ba1\u901a\u8def\u7684\u7ba1\u7406\u5e94\u91cd\u89c6\u4e2a\u4f53\u7684\u6807\u51c6\u5316\u6cbb\u7597\u3002\u8fd0\u52a8\u5eb7\u590d\u3001\u7269\u7406\u68c0\u67e5\u3001\u8d85\u58f0\u9020\u5f71\u52a9\u529b\u8840\u7ba1\u901a\u8def\u5168\u7a0b\u7ba1\u7406\u3002\u57fa\u4e8e\u4eba\u5de5\u667a\u80fd\u7684\u4e00\u4f53\u5316\u6cbb\u7597\u662f\u672a\u6765\u8840\u7ba1\u901a\u8def\u7684\u524d\u8fdb\u65b9\u5411\u3002<\/p>\n \u53c2\u8003\u6587\u732e\uff1a\uff08\u4e0a\u4e0b\u6ed1\u52a8\u67e5\u770b\u66f4\u591a\uff09<\/p>\n [1]. \u4e2d\u56fd\u8840\u6db2\u51c0\u53162020\u5e741\u6708\u7b2c19\u5377\u7b2c1\u671fChin J Blood Purif,January,2020,Vol.19,No.1<\/p>\n [2]. JNephrol.2021 Jun;34(3):763-771. doi:10.1007\/s40620-020-00907-w.Epub 2021 Jan 2.<\/p>\n [3]. Blood Purif, 2020, 49(1-2): 16-24.<\/p>\n [4]. J Vasc Access, 2020, 21(5): 602-608.<\/p>\n [5]. Hemodial Int, 2021, 25(2): 154-163.<\/p>\n [6]. J Vasc Access, 2020, 21(3): 372-378.<\/p>\n [7]. J Vasc Access, 2013, 14(3): 239-244.<\/p>\n [8]. BMC Nephrol, 2017, 18(1): 198.<\/p>\n [9]. Biosensors (Basel), 2021, 11(9).<\/p>\n [10]. Sci Rep, 2023, 13(1): 17659.<\/p>\n [11]. 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