【摘要】 目的研究在进行联机血液透析滤过(On-line Hemodiafiltration,On-line HDF)治疗前管路预冲结束待患者上机时间与首次使用综合征(First-use syndrome,FUS)之间的关系。方法选用2013年1—12月在苏州大学附属第三医院血液净化中心接受On-line HDF治疗的187患者(共接受17 280例次Online HDF治疗)为研究对象。根据On-line HDF密闭循环超滤结束后的待患者上机时间(t),将t=0 min设为观察组,将0 min<t≤15 min、15 min<t≤30 min和t>30 min的患者数据分别记录为对照1组、对照2组和对照3组。同时记录四组在治疗过程中发生FUS的次数、类型和特点并进行统计学分析。结果 17280例次On-line HDF患者共发生721例次FUS(发生率4.172%),其中A型1例次(发生率0.012%),B型720例次(发生率4.170%)。A型FUS发生人次4组不同待患者上机时间(t)相比无统计学差异(χ2=1.248,P=0.742);B型FUS发生人次4组不同待患者上机时间(t)相比有统计学差异(χ2=531.604,P<0.001)。结论缩短待患者上机时间能够达到降低B型FUS的发生率的效果。更多还原

【Abstract】 Objective To investigate the effects of different time between pipeline flushing time and online Hemodiafiltration( on-line HDF) to prevent the first-use syndrome( FUS). Methods One hundred and eighty-seven maintenance hemodialysis( MHD) patients undergoing a total of 17,280 cases of times on-line HDF therapy in the Blood Purification Center of The Third Affiliated Hospital of Soochow University from January to December 2013 were enrolled in this retrospective study. Seventeen thousand and two hundred eighty cases of online HDF were divided into four groups according to different time between pipeline flushing time and on-line Hemodiafiltration: Observation group( t = 0min),control group Ⅰ( 0 min < t≤15 min),control groupⅡ( 15min < t≤30min) and control groupⅢ( t > 30min). The incidence,type and the feature of FUS in the four groups were recorded and statistically analyzed. Results The incidence of FUS was 721( 4. 172%)( Type A = 1,0. 012%; Type B = 720,4. 170%) in 17280 cases of on-line HDF. There was no significant difference between the incidences of FUS of Type A in four groups( χ2= 1. 248,P = 0. 742). Compared with the three other groups, observation group showed a significant decrease of incidence of FUS of Type B( χ2= 531. 604,P < 0. 001). Conclusions Reducing the time between the pipeline flushing and on-line HDF is likely to be an effective method to decrease the incidence of FUS of type B.更多还原