{"id":5315,"date":"2023-07-17T21:37:44","date_gmt":"2023-07-18T02:37:44","guid":{"rendered":"https:\/\/staging.advancedrenaleducation.com\/wparep\/asiapacific\/?post_type=article&p=5315"},"modified":"2023-07-17T21:56:28","modified_gmt":"2023-07-18T02:56:28","slug":"%e5%b0%8d%e6%b5%81%e5%ae%b9%e9%87%8f%e4%b9%8b%e9%97%9c%e9%8d%b5%e8%a7%92%e8%89%b2%e5%8f%8a%e5%af%a6%e5%8b%99%e7%b5%90%e6%9e%9c-critical-role-of-convection-volume-and-practices-on-results","status":"publish","type":"article","link":"https:\/\/staging.advancedrenaleducation.com\/wparep\/asiapacific\/article\/%e5%b0%8d%e6%b5%81%e5%ae%b9%e9%87%8f%e4%b9%8b%e9%97%9c%e9%8d%b5%e8%a7%92%e8%89%b2%e5%8f%8a%e5%af%a6%e5%8b%99%e7%b5%90%e6%9e%9c-critical-role-of-convection-volume-and-practices-on-results\/","title":{"rendered":"\u5c0d\u6d41\u5bb9\u91cf\u4e4b\u95dc\u9375\u89d2\u8272\u53ca\u5be6\u52d9\u7d50\u679c"},"content":{"rendered":"

\u5728\u900f\u6790\u4e2d\u5982\u4f55\u4f7f\u7528\u5c0d\u6d41\u7684\u5bb9\u91cf\u4ee5\u53ca\u6e2c\u91cf\u56e0\u5b50\uff0c\u4f86\u63d0\u5347\u6cbb\u7642\u7d50\u679c\uff0c\u662f\u975e\u5e38\u91cd\u8981\u7684\u554f\u984c (1,2)\u3002\u5291\u91cf\u9700\u6839\u64da\u5404\u5730\u7684\u5be6\u52d9\u60c5\u6cc1\u3001\u4ee5\u53ca\u60a3\u8005\u72c0\u6cc1\u4f86\u6c7a\u5b9a\uff0c\u5fc5\u9808\u7b26\u5408\u500b\u5225\u60a3\u8005\u7684\u65b0\u9673\u4ee3\u8b1d\u9700\u6c42\uff0c\u9084\u6709\u6bcf\u4f4d\u60a3\u8005\u5c0d\u65bc\u8840\u6db2\u52d5\u529b\u7684\u5bb9\u5fcd\u5ea6\u3002<\/p>\n

\u5728\u897f\u65b9\u53ca\u6b50\u6d32\u5730\u5340\uff0c\u8d85\u904e90%\u7684HDF\u6cbb\u7642\u60a3\u8005\u63a1\u7528\u5f8c\u7a00\u91cb\u6cd5HDF\u3002CONTRAST\u662f\u7b2c\u4e00\u500b\u4f86\u56de\u61c9\u5c0d\u6d41\u5291\u91cf\u7684\u96a8\u6a5f\u5c0d\u7167\u8a66\u9a57\u7814\u7a76\uff0c\u63a1\u7528\u4e864\u5c0f\u6642\u6cbb\u7642\u4f7f\u752824 L \u5c0d\u6d41\u91cf\u7684\u8a2d\u8a08\u3002\u4f46\u4e0d\u5e78\u5730\uff0c\u56e0\u70ba\u5404\u5730\u898f\u7bc4\u6216\u662f\u8a13\u7df4\u4e0d\u8db3\uff0c\u5be6\u969b\u7684\u5c0d\u6d41\u5bb9\u91cf\u7684\u4e2d\u4f4d\u6578\u53ea\u670919.8 L (3,4,5)\u3002\u4e8b\u5f8c\u5206\u6790\u767c\u73fe\uff0c\u5b58\u6d3b\u7387\u986f\u8457\u8207\u8f03\u9ad8\u7684\u5c0d\u6d41\u5bb9\u91cf\u6709\u95dc\uff0c\u9700\u8981\u9ad8\u904e21.95 L (6)\u3002\u5728\u571f\u8033\u5176\u7684HDF\u7814\u7a76\uff0c\u63a1\u7528\u7684\u88dc\u5145\u6db2\u7684\u5bb9\u91cf\u81f3\u5c11\u898115L\uff0c\u800c\u4e2d\u4f4d\u6578\u7684\u88dc\u5145\u6db2\u5bb9\u91cf\u70ba17.2 L (7)\uff0c\u7814\u7a76\u7d50\u679c\u8207CONTRAST\u985e\u4f3c\uff0cHDF\u8207HD\u5728\u5b58\u6d3b\u7387\u6c92\u6709\u5dee\u7570\uff0c\u4f46\u518d\u6b21\u5730\uff0c\u4e8b\u5f8c\u5206\u6790\u986f\u793a\u5c0d\u6d41\u5bb9\u91cf>19.9 L (\u5305\u542b 2.5 L \u9ad4\u91cd\u6e1b\u5c11)\u6703\u63d0\u5347\u5b58\u6d3b\u7387\u3002\u9019\u5169\u500b\u4e8b\u5f8c\u5206\u6790\u7684\u7d50\u679c\uff0c\u4e5f\u88abESHOL\u7814\u7a76\u7d50\u679c\u8b49\u5be6\uff0c\u767c\u73fe\u60a3\u8005\u6bcf\u6b21\u82e5\u63a1\u7528\u9ad8\u905423.1 L\u7684\u5c0d\u6d41\u5bb9\u91cf\uff0c\u6bd4\u8d77\u9ad8\u900f\u91cfHD\uff0c\u6703\u986f\u8457\u63d0\u5347\u5b58\u6d3b (8)\u3002<\/p>\n

\u5728\u5176\u4ed6\u5927\u898f\u6a21\u7684\u5291\u91cf\u7814\u7a76\u4e2d\uff0c\u4e5f\u540c\u6a23\u6307\u51fa\u4e86\u5c0d\u6d41\u5bb9\u91cf\u8207\u60a3\u8005\u6cbb\u7642\u7d50\u679c\u7684\u76f8\u95dc\u6027 (9)\uff0c\u6839\u64da\u6a23\u689d\u66f2\u7dda\u5206\u6790 (spline curve analysis)\u767c\u73fe\uff0c\u5c0d\u6d41\u5bb9\u91cf\u8207\u60a3\u8005\u6cbb\u7642\u7d50\u679c\u7684\u76f8\u95dc\u6027\u61c9\u8a72\u88ab\u8996\u70ba\u4e00\u500b\u9023\u7e8c\u6027\u4e14\u7368\u7acb\u7684\u8b8a\u6578\u3002\u6b64\u5916\uff0c\u5206\u6790\u4e2d\u4e5f\u767c\u73fe\u8840\u6e05\u03b22-microglobulin \u8207 CRP\u6fc3\u5ea6\uff0c\u8207\u5291\u91cf\u5c0d\u6d41\u5bb9\u91cf\u5448\u73fe\u8ca0\u76f8\u95dc (9)\u3002\u53e6\u5916\uff0c\u6700\u8fd1\u7684\u897f\u73ed\u7259\u4e16\u4ee3\u7814\u7a76\uff0c\u63a1\u7528\u50be\u5411\u6027\u5339\u914d\u5206\u67901,012\u5c0d\u60a3\u8005\uff0c\u4f86\u6bd4\u8f03\u9ad8\u900f\u91cfHD\u8207HDF\uff0c\u767c\u73feHDF\u6cbb\u7642\u7684\u60a3\u8005\u70ba\u63a5\u53d7\u4e2d\u4f4d\u6578\u70ba23.45 (IQ 21.27-25.51) L\/\u6b21\u7684\u88dc\u5145\u6db2\uff0c\u53ef\u4ee5\u5206\u5225\u6e1b\u5c1124 % \u8207 33% \u7684\u6574\u9ad4\u6b7b\u4ea1\u7387\u3001\u4ee5\u53ca\u5fc3\u8840\u7ba1\u6b7b\u4ea1\u7387 (10)\u3002<\/p>\n

\u5728\u65e5\u672c\uff0c\u524d\u7a00\u91cbHDF\u662f\u6700\u4e3b\u8981\u7684\u4f7f\u7528\u65b9\u5f0f\uff0c\u4f54\u4e8680-90%\u7684HDF\u6cbb\u7642\uff0c\u6b64\u6e90\u65bc\u8840\u7ba1\u901a\u8def\u7684\u6d41\u901f\u9650\u5236\u4ee5\u53ca\u5730\u65b9\u898f\u7bc4 (5,11)\u3002\u4f46\u76ee\u524d\u6c92\u6709\u524d\u77bb\u6027\u7684\u814e\u81df\u66ff\u4ee3\u7642\u6cd5\u5e72\u9810\u6027\u7814\u7a76\u63a1\u7528\u524d\u7a00\u91cb\u6a21\u5f0f\uff0c\u63a2\u8a0e\u7cbe\u78ba\u7684\u5c0d\u6d41\u5bb9\u91cf\u6240\u9020\u6210\u7684\u5f71\u97ff\u3002\u4e0d\u904e\uff0c\u5728\u6700\u8fd1\u7684JSDT (Japanese Society for Dialysis Therapy) \u7814\u7a76\u4ee5\u53ca\u66f4\u591a\u6a23\u689d\u51fd\u6578\u5206\u6790\u4e2d\uff0c\u5728\u5206\u6790\u5c0d\u6d41\u5bb9\u91cf\u8207\u60a3\u8005\u6cbb\u7642\u7d50\u679c\uff0c\u767c\u73fe\u5bb9\u91cf\u9ad8\u905440 L\/\u6b21\uff0c\u59cb\u53ef\u4ee5\u958b\u59cb\u770b\u5230\u5c0d\u65bc\u5b58\u6d3b\u5e36\u4f86\u7684\u597d\u8655\uff0c\u800c\u6700\u4f73\u8868\u73fe\u5bb9\u91cf\u53ef\u80fd\u662f\u5728 50 L\/\u6b21\u3002\u4e5f\u5c31\u662f\u8aaa\uff0c\u524d\u7a00\u91cb\u6a21\u5f0f\u7684\u5c0d\u6d41\u5291\u91cf\uff0c\u6bd4\u8d77\u6b50\u6d32\u5e38\u898b\u7684\u5f8c\u7a00\u91cb\u6a21\u5f0f\uff0c\u9700\u8981\u5e7e\u4e4e\u5169\u500d\u7684\u5291\u91cf\u624d\u80fd\u9054\u5230\u540c\u6a23\u597d\u7684\u7d50\u679c\u3002\u5c0d\u6d41\u5291\u91cf\u589e\u9032\u60a3\u8005\u5b58\u6d3b\u662f\u7121\u5eb8\u7f6e\u7591\u7684\uff0c\u5728\u65e5\u672c\u7684\u524d\u7a00\u91cb\u6a21\u5f0f\uff0c\u7121\u8ad6\u7528\u4ec0\u9ebc\u8abf\u6574\u56e0\u5b50 (\u4f8b\u5982\uff0c\u9ad4\u91cd\u3001BMI\u3001\u8eab\u9ad4\u6c34\u91cf\u3001\u6216\u8eab\u9ad4\u8868\u9762\u7a4d)\uff0c\u7686\u53ef\u770b\u5230\u8207\u6b50\u6d32\u7814\u7a76\u6709\u8457\u540c\u6a23\u7684\u597d\u8655\u3002<\/p>\n

\u7c21\u800c\u8a00\u4e4b\uff0c\u6700\u8fd1\u7684\u7814\u7a76\u767c\u73fe\uff0c\u6700\u4f73\u7684\u5c0d\u6d41\u5291\u91cf\u53ef\u4ee5\u63d0\u5347\u900f\u6790\u60a3\u8005\u7684\u6cbb\u7642\u7d50\u679c\uff0c\u9019\u4e9b\u7814\u7a76\u57fa\u790e\u662f\u7121\u5c3f\u60a3\u8005\u6bcf\u5468\u4e09\u6b21\u7684\u6cbb\u7642\uff0c\u4e26\u4e14\u4ee5\u81f3\u5c11<\/strong> 23 L\/<\/strong>\u6b21<\/strong> \u7684\u5f8c\u7a00\u91cb\u65b9\u6cd5<\/strong> \u00a0<\/strong>(26 L\/1.73m2<\/sup>) <\/strong>\u6216<\/strong> 46 L\/<\/strong>\u6b21\u7684\u524d\u7a00\u91cb\u6a21\u5f0f<\/strong> (52 L\/1.73m2<\/sup>)<\/strong>\u3002<\/p>\n

\u9019\u6a23\u7684\u5c0d\u6d41\u5291\u91cf\u7121\u6cd5\u61c9\u7528\u5728\u7279\u6b8a\u7684\u900f\u6790\u7642\u7a0b\uff0c\u8af8\u5982\u6bcf\u5929\u3001\u591c\u9593\u6216\u662f\u589e\u52a0\u7684\u900f\u6790\u6cbb\u7642\u6392\u7a0b\uff0c\u4e14\u9019\u4e9b\u6cbb\u7642\u503c\u5f97\u66f4\u9032\u4e00\u6b65\u7684\u7814\u7a76\u4f86\u8861\u91cf\u6548\u76ca\u8207\u98a8\u96aa\u3002\u7121\u8ad6\u5982\u4f55\uff0c\u5c11\u6578\u81e8\u5e8a\u7814\u7a76\u9ede\u51fa\uff0c\u589e\u52a0HDF\u6cbb\u7642\u7684\u6642\u9593\uff0c\u7121\u8ad6\u662f\u589e\u52a0\u6bcf\u6b21\u66f4\u9577\u7684\u6cbb\u7642\u6642\u9593 (8\u5c0f\u6642\uff0c\u4e00\u54683\u6b21)\u6216\u662f\u6bcf\u5169\u5929\u4e00\u6b21\u7684\u9593\u9694\u6cbb\u7642 (12-14)\uff0c\u5728\u6240\u6709\u8abf\u67e5\u7684\u500b\u6848\u4e2d\uff0c\u53ef\u4ee5\u770b\u5230\u7684\u81e8\u5e8a\u6548\u76ca\uff0c\u5305\u542b\u66f4\u597d\u7684\u8840\u58d3\u8207\u9ad4\u5167\u6db2\u9ad4\u8abf\u63a7\u72c0\u6cc1\u3001\u6e1b\u5c11\u6539\u5584\u8ca7\u8840\u7684ESA\u4f7f\u7528\u5291\u91cf\u3001\u4ee5\u53ca\u66f4\u597d\u7684\u78f7\u96e2\u5b50\u63a7\u5236\uff0c\u751a\u81f3\u4e0d\u518d\u9700\u8981\u78f7\u96e2\u5b50\u88dc\u5145 (13)\u3002<\/p>\n

(Translated from Website link: https:\/\/staging.advancedrenaleducation.com\/wparep\/article\/critical-role-of-convection-volume-and-practices-on-results\/)<\/p>\n

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