目的:观察W-F168-B型和RENATRONⅡ型透析器复用机临床应用对患者透析质量的影响。方法:符合纳入标准的受试者随机分为2组,试验组和对照组的透析器分别用W-F168-B和RENATRONⅡ复用。测定受试者透析前后血红蛋白、白蛋白、肌酐、尿素氮,计算尿素清除率除以分布容积(Kt/V,K为尿素清除率,t为透析时间,V为分布容积)。结果用均数±标准差表示,采用成组设计的t检验,spss13.0统计软件包分析。结果:试验组和对照组Kt/V值分别为1.25±0.26和1.24±0.19,透析前后血红蛋白差值分别为(1.32±0.14)g/L和(1.34±0.27)g/L,白蛋白差值分别为(0.86±0.05)g/L和(0.79±0.18)g/L。t 检验示两组以上各值比较差异无统计学意义(Pgt;0.05)。结论:两种透析器复用机对受试者透析充分性的影响无明显差异,能达到较好的透析质量。
ObjectivesTo systematically review the influence for catheter mechanical dysfunction of different peritoneal dialysis catheterization methods.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were searched to collect randomized controlled trials (RCTs) and cohort studies on comparisons of different peritoneal dialysis catheterization from inception to March 31st, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Network meta-analysis was then performed by using ADDIS 1.16.6 software.ResultsA total of 33 studies (9 RCTs and 24 cohort studies) involving 3 301 patients were included. Network meta-analysis showed that the incidence of catheter mechanical dysfunctionwas the least and had statistically significant difference compared with that in percutaneous catheterization (OR=3.60; 95%CI, 1.64 and 15.38) and open surgery catheterization (OR=5.86; 95%CI, 2.68 and 14.53). Percutaneous catheterization was superior to open surgery catheterization, but there was no significant difference.ConclusionsLaparoscopic catheterization may be the best technique for catheter insertion in peritoneal dialysis considering catheter dysfunction. Each technology has its own advantages. Choice of insertion method should be based on the characteristics of both the patient and the insertion techniques.
To diagnose and treat a patient with rare lupus erythematosus-like syndrome and antineutrophil cytoplasmic antibodies (ANCA) positive vasculitis with graves’ disease by applying the approach of evidence-based medicine. Clinical problems were raised based on the patient condition and PubMed (1966-2003), CBM (1978-2003), EMBASE (1974-2003) were searched for the related information. We found that the best explaination for this case was antithyroid drugs’ side effect, and the patient was obvious better after treatment.