連續性腎臟取代療法的介紹

The Introduction of Continuous Renal Replacement Therapy

王家良(Chia-Liang Wang) ； 楊得政(Te-Cheng Yang) ； 王守玠(Shou-Chieh Wang) ； 張淑鈺(Shu-Yu Chang) ； 鄭凌寶(Ling-Pao Cheng)

《腎臟與透析》 32卷1期 (2020/03) Pp. 31-34

https://doi.org/10.6340/KD.202003_32(1).0007

摘要

一旦急性腎損傷惡化到需要腎臟取代療法（renal replacement therapy, RRT）的情形，常常因為不穩定的血流動力學，而無法執行傳統血液透析，而需要執行連續性腎臟取代療法（continuous renal replacement therapy, CRRT）。CRRT方式包括連續靜脈血液濾過（continuous venovenous hemofiltration, CVVH），連續靜脈血液透析（continuous venovenous hemodialysis, CVVHD）和連續靜脈血液透析濾過（continuous venovenous hemofiltration, CVVHDF）。選擇CRRT主要為了血流動力學不穩定、急性腦傷和肝衰竭。隨機試驗尚未證明CRRT引起較少的低血壓和較優的存活率。CRRT方式的選擇取決於臨床判斷、設備和護理人力。

關鍵字

急性腎損傷 ； 腎臟取代療法 ； 連續性腎臟取代療法

並列摘要

When acute kidney injury developed and exacerbated, complications of renal failure such as hyperkalemia, metabolic acidosis, fluid overloading were noted, conventional hemodialysis often could not be performed due to unstable hemodynamic status, continuous renal replacement therapy (CRRT) was necessary. CRRT modalities included continuous venovenous hemofiltration, continuous venovenous hemodialysis, and continuous venovenous hemodiafiltration. CRRT is particularly beneficial for unstable hemodynamic status, acute brain injury and liver failure. No random control trial proved CRRT resulted in less hypotension and mortality. The choice of CRRT modalities depend on clinical judgment, equipment and the availability of dialysis nursing staff.

並列關鍵字

acute kidney injury ； renal replacement therapy ； continuous renal replacement therapy