Ward R A, Farrell P C, Tiller D J, Horvath J S, Freeman J M
Aust N Z J Med. 1976 Aug;6(4):288-91. doi: 10.1111/imj.1976.6.4.288.
A large-area short-time (LAST) haemodialysis regimen (three hours by three times per week on a 2-5 M2 haemodialyser) has been compared with conventional haemodialysis (six hours by three times per week on a 1-3 M2 haemodialyser) on four patients over a period of eight months. Parameters monitored throughout the study included: Serum biochemistries, haematocrit, extra-cellular fluid space, platelet function, granulocyte kinetics, immunological status and neurological status. All patients showed weight increases (3--12%) during the LAST dialysis period. These increases were related to problems of intradialytic hypotension which resulted from the increased rate of fluid removal required during the LAST dialysis period. Hypotension was not a problem during routine dialysis all patients showed an increase of 10--20% (P less than 0-05) in predialysis serum urea and creatinine and a moderate decrease in predialysis serum bicarbonate (from 24-8 +/- 2-2 to 21-4 +/- 2-6 mM/I, P less than 0-005). This study indicates that, providing fluid balance can be controlled, a LAST dialysis regimen provides comparable therapy to conventional haemodialysis. However, recent studies have suggested that short-time dialysis may be possible with conventional 1-0 to 1-3 M2 haemodialysers, indicating that short-time haemodialysis may not need to involve more costly large-area haemodialysers.
在8个月的时间里，对4名患者采用大面积短时（LAST）血液透析方案（使用2 - 5平方米的血液透析器，每周3次，每次3小时）与传统血液透析（使用1 - 3平方米的血液透析器，每周3次，每次6小时）进行了比较。整个研究过程中监测的参数包括：血清生化指标、血细胞比容、细胞外液量、血小板功能、粒细胞动力学、免疫状态和神经状态。所有患者在LAST透析期间体重均增加（3% - 12%）。这些增加与透析期间低血压问题有关，这是由于LAST透析期间所需的液体清除率增加所致。常规透析期间低血压不是问题，所有患者透析前血清尿素和肌酐增加10% - 20%（P < 0.05），透析前血清碳酸氢盐适度下降（从24.8 ± 2.2降至21.4 ± 2.6 mM/L，P < 0.005）。这项研究表明，只要能控制液体平衡，LAST透析方案与传统血液透析提供的治疗效果相当。然而，最近的研究表明，使用传统的1.0至1.3平方米血液透析器也可能进行短时透析，这表明短时血液透析可能无需使用更昂贵的大面积血液透析器。
