الملخص
Objective:To explore the application value of central venous indwelling catheter guided by ultrasound in temporary hemodialysis patients.Methods:Seven hundred and eight cases of hemodialysis patients were choosed as the respondents who were divided into control group(n=386) and ultrasound group(n=322), sex ratio, average age, disease distribution, platelet count(Plt), prothrombin time(PT), systolic blood pressure (SBP), neck circumference was no statistical difference in two groups. In control group, indwelling catheter of the right internal jugular vein were implemented in the triangle area formed by sternocleidomastoid clavicular head, sternum, clavicle by using surface anatomic mapping. In ultrasound group, position, the diameter and blood flow filling situation of the right internal jugular vein by using ultrasound scan, the veins were punctured and indwelled catheter under the guided by ultrasound. The success rates and times of indwelling catheter, as well as complications were compared between two groups.Results: One-time success rate of indwelling catheter guided by ultrasound group was obviously higher than that of control group, the rates were statistically significant difference (x2=118.82,P<0.01), and the indwelling time was significantly shorter than that of control group, The difference was statistically significant (t=7.03,P<0.01). The puncture comfort score of ultrasound group was significantly higher than that of control group, The difference was statistically significant (t=6.29,P<0.01). The complication rate of ultrasound group was lower than that of control group, the difference was statistically significant (x2=28.24,P<0.01).Conclusion: Ultrasound help to understand the position, diameter and blood flow filling situation of the right internal jugular vein, improve the success rate of indwelling catheter and reduce the occurrence of complications.
الملخص
Objective:To observe the effect of high-flux polyethersulfone dialysis membrane to inflammatory mediators and nutritional status in patients with maintenance hemodialysis, and to explore its mechanism.Methods: Ninety six patients with low-flux maintainance hemodialysis were recruited after changing to a high-flux hemodialysis. Hs-CRP, IL-1, IL-6,ALB, Hb,β2-MG were tested before treatment, 6 months and 12 months after treatment, at the same time single chamber urea clearance index (spKt/V) was recorded. Results:①The compare results among high-flux polysulfone membrane dialysis treatment for 6 months and after 12 months, and before treatment, hs-CRP andβ2-MG significantly decreased (F=6.53,P<0.05), spKt/V was significantly higher(F=4.35, P<0.05), and IL-6 significantly decreased at 12 months after treatment, compared with before treatment, the difference was statistically significant (F=7.21,P<0.05).②There was significantly negative correlation between hs-CRP and ALB (r=-0.463,r=-0.396,r=-0.402;P<0.05). Inflammatory mediators may participate in the occurrence and development of its hypoalbuminemia in MHD patients, and elevated hs-CRP levels may be a risk factor for hypoalbuminemia. Conclusion:High-flux polysulfone membrane hemodialysis can effectively reduce micro-inflammatory state MHD patients and improve their nutritional status, improve the quality of life and long-term survival.
الملخص
Regional saturation technique has been applied in MR scaning widely. It is possible to obtain MRA or MRV by putting the REST slab on one side of slice or another. REST eliminates artifacts caused by motion or blood flow and minimizers wrap artifacts along the phase encoding and high quality of images can be provided.