Kaizu Kazo, Inada Yoshifumi, Kawamura Akio, Oda Seito, Hirasawa Hiroyuki
Contrib Nephrol. 2010;166:4-10. doi: 10.1159/000314844. Epub 2010 May 7.
In order to clarify the present status of blood purification therapy (BPT) in critical care in Japan, questionnaires investigating all the patients who were treated with BPT in 2005 were distributed. The number of patients who received BPT was 9,795, and the number of BPT performed was 11,623. The number and types of BPT treatment given are: continuous hemodiafiltration (CHDF)/hemofiltration (HDF) 5,443 (50.3%); continuous hemofiltration (CHF) 812 (7.5%); continuous hemodialysis (CHD) 877 (8.1%); simple plasma exchange 898 (8.3%); direct hemoperfusion (DHP) with polymyxin-B-coated textile (PMX-DHP) 1,625 (15.0%); DHP with activated carbon (AC-DHP) 129 (1.2%). The survival rates of patients with continuous therapies (CHDF, CHF, CHD) were as follows: multiple organ failure with CHDF 35%; sepsis with CHDF 65%; acute hepatic failure with CHDF 50%; acute renal failure with CHDF 66%; acute drug intoxication with AC-DHP 79%. In conclusion, continuous therapies such as CHDF, CHF and CHD were the most popular modes (> 65%) of BPT in Japan. The worst survival rate among diseases in critical care was found in multiple organ failure patients. The best survival rate was in those who suffered from acute renal failure.
为明确血液净化疗法（BPT）在日本重症监护中的现状，我们分发了调查问卷，调查2005年接受BPT治疗的所有患者。接受BPT治疗的患者有9795例，进行的BPT治疗次数为11623次。BPT治疗的次数和类型如下：连续性血液透析滤过（CHDF）/血液滤过（HDF）5443次（50.3%）；连续性血液滤过（CHF）812次（7.5%）；连续性血液透析（CHD）877次（8.1%）；单纯血浆置换898次（8.3%）；用多粘菌素B包被纤维柱的直接血液灌流（PMX-DHP）1625次（15.0%）；用活性炭的直接血液灌流（AC-DHP）129次（1.2%）。连续性治疗（CHDF、CHF、CHD）患者的生存率如下：CHDF治疗的多器官功能衰竭患者为35%；CHDF治疗的脓毒症患者为65%；CHDF治疗的急性肝衰竭患者为50%；CHDF治疗的急性肾衰竭患者为66%；AC-DHP治疗的急性药物中毒患者为79%。总之，在日本，CHDF、CHF和CHD等连续性治疗是BPT最常用的模式（>65%）。重症监护疾病中生存率最差的是多器官功能衰竭患者。生存率最高的是急性肾衰竭患者。
