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缓慢持续超滤(SCUF)——心力衰竭和液体超负荷患者的安全有效治疗方法。

Slow continuous ultrafiltration (SCUF)--the safe and efficient treatment for patients with cardiac failure and fluid overload.

作者信息

Wei S S, Lee W T, Woo K T

机构信息

Department of Renal Medicine, Singapore General Hospital, Singapore.

出版信息

Singapore Med J. 1995 Jun;36(3):276-7.

PMID:8553091
Abstract

Slow Continuous ultrafiltration (SCUF) was first used in 1980 as an alternative mode of fluid removal for patients with oliguric acute renal dysfunction from whatever causes. The advantage of this treatment is that haemodynamic parameters remain stable in the presence of significant removal of fluid. We are describing our experience in 7 patients [age: 57 +/- 9 years; 4 male, 3 female] with cardiac failure and fluid overload who had undergone 8 sessions of SCUF. All of them had renal impairment and were resistant to diuretics. Blood lines were attached to a Kawasumi Renak-E dialyser (Cuprophane membrane) in series using Gambro AK10 dialysis blood pump. The following parameters were monitored: Blood pump (Qb): 175 +/- 26 ml/min, time (T): 393 +/- minutes. Venous pressure averaged a55 +/- 24 mmHg. We achieved ultrafiltration of 2,189 +/- 699 ml/session or 5.5 +/- 1.7 ml/hr. There was no significant change in blood pressure [systolic pre: 143 +/- 14, post: 136 +/- 13 mmHg, not significant; diastolic pre: 87 +/- 10, post: 83 + 10 mmHg, not significant and pulse rate [pre: 87 +/- 9 vs post: 84 +/- 2 per minute, not significant. Heparin dosage averaged 274 +/- 26 IU/hr during the SCUF. We conclude that SCUF is beneficial to diuretic resistant patients with cardiac failure and fluid overload in whom dialysis treatment is not required.

摘要

缓慢持续超滤(SCUF)于1980年首次被用作无论何种原因导致少尿性急性肾功能不全患者的一种替代液体清除模式。这种治疗的优点是在大量清除液体的情况下血流动力学参数保持稳定。我们正在描述7例[年龄:57±9岁;4例男性,3例女性]心力衰竭和液体超负荷患者接受8次SCUF治疗的经验。他们均有肾功能损害且对利尿剂耐药。使用金宝AK10透析血泵将血路管串联连接到川澄Renak - E透析器(铜仿膜)上。监测了以下参数:血泵(Qb):175±26毫升/分钟,时间(T):393±分钟。静脉压平均为55±24毫米汞柱。我们每次治疗实现超滤2189±699毫升或每小时5.5±1.7毫升。血压[收缩压:治疗前143±14,治疗后136±13毫米汞柱,无显著差异;舒张压:治疗前87±10,治疗后83 + 10毫米汞柱,无显著差异]和脉搏率[治疗前:87±9次/分钟与治疗后:84±2次/分钟,无显著差异]均无显著变化。SCUF期间肝素剂量平均为274±26国际单位/小时。我们得出结论,SCUF对不需要透析治疗的心力衰竭和液体超负荷且对利尿剂耐药的患者有益。

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