天津医药 ›› 2018, Vol. 46 ›› Issue (6): 571-576.doi: 10.11958/20180415

• 专题研究·重症医学-专家论坛 • 上一篇    下一篇

关注CRRT的热点问题

胡振杰,刘丽霞   

  1. 河北医科大学第四医院重症医学科(邮编050011)
  • 收稿日期:2018-03-19 修回日期:2018-06-05 出版日期:2018-06-15 发布日期:2018-07-05
  • 通讯作者: 胡振杰 E-mail:syicu@vip.sina.com

Focus on the hotspots of CRRT

HU Zhen-jie, LIU Li-xia   

  1. Department of Critical Care Medicine, the 4th Hospital of Hebei Medical University, Shijiazhuang 050011,China
  • Received:2018-03-19 Revised:2018-06-05 Published:2018-06-15 Online:2018-07-05

摘要: 随着科技的进步和重症肾脏医学的发展,连续性肾脏替代治疗(CRRT)已经从旨在纠正几个危及生命的肾功能损伤(AKI)的严重并发症扩展到进行肾脏支持,并得到广泛应用,但随之带来了许多争议和问题,包括启动CRRT的时机、治疗剂量和选择什么样的滤器膜材质。60年的争论和研究并没有得出一致结论,而这种争议恰恰反映了重症患者病情的复杂性,并不存在“一成不变(one size fits all)”的治疗模式,而应该是“以患者为中心的、个体化的精准CRRT”治疗模式。本文旨在通过对以上3个热点问题进行深入探讨,以期为临床医生进行合理化、个体化、精 准CRRT治疗提供依据,让更多患者获益。

关键词: 连续性肾脏替代治疗, 时机, 剂量,

Abstract: With the progress of technology and the development of severe kidney medicine, continuous renal replacement therapy (CRRT) has been extended to kidney support and has been widely used for aiming to rapidly correct fatal complications of several life-threatening renal impairment (AKI). However, there are many controversies and problems,including the timing of initiating CRRT, the dosage of treatment and the choice of filter membrane material for different kinds of critically ill patients. The controversy and study of 60 years have not come to a unanimous conclusion, which reflects the critically clinical complexity. There is no "unchangeable (one size fits all)" treatment model, but rather a "patientcentered, individualized, precision CRRT" treatment. This article was to explore these three hotspots in order to provide more evidences for clinicians to perform rationalized, personalized and precise CRRT, and to make more patients benefit from CRRT.

Key words: continuous renal replacement therapy, timing, dose, membrane