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目的探讨应用生物电阻抗分析法(BIVA)评估急性肾损伤(AKI)行连续性肾脏替代治疗(CRRT)患者液体负荷变化的价值。方法选取22例终末期肾脏病行维持性血液透析的患者(透析组)、35例AKI行CRRT的患者(CRRT组)和14例健康志愿者(正常对照组),在透析组和CRRT组透析前后、正常对照组饮水前后行BIVA检测,分析三组体重变化、前后两次BIVA检测之间的净出入量与BIVA液体负荷变化值的相关性。结果三组中,正常对照组饮水前后BIVA参数变化值最小,透析组透析前后BIVA参数变化值最大。透析组和CRRT组透析前后两次BIVA检测之间的净出入量与液体负荷变化值差异均无统计学意义(P>0.05)。透析组和CRRT组体重变化与BIVA参数中全身水含量、细胞外液及液体负荷变化值相关(P<0.05),但与细胞内液变化值无明显相关性(P>0.05)。结论 AKI行CRRT患者可应用BIVA评估液体负荷的变化,指导容量管理。
Objective To evaluate the value of bioelectrical impedance analysis (BIVA) in assessing the change of fluid load in patients with acute renal injury (AKI) undergoing continuous renal replacement therapy (CRRT). Methods Twenty-two patients with end-stage renal disease undergoing hemodialysis (dialysis group), 35 CRI-treated patients with AKI (CRRT group) and 14 healthy volunteers (normal control group) were enrolled in this study. Dialysis was performed in dialysis group and CRRT group Before and after, the control group before and after drinking water BIVA test, analysis of weight changes in the three groups, before and after the two BIVA test the net amount of fluid changes and BIVA load changes in the relevance. Results In the three groups, the changes of BIVA parameters before and after drinking water in the normal control group were the lowest, and those in the dialysis group before and after dialysis were the highest. There were no significant differences in the changes of net load and liquid load between dialysis group and CRRT group before and after dialysis (P> 0.05). Body weight changes in dialysis group and CRRT group were correlated with changes of whole body water content, extracellular fluid and fluid load in BIVA parameters (P <0.05), but no significant correlation with body fluid changes (P> 0.05). Conclusion Patients with AKR who have CRRT may be assessed for changes in fluid load using BIVA to guide capacity management.