Renal replacement therapy and the elderly

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药物替代疗法英语作文初中

In the realm of healthcare, the concept of alternative medicine has gained significant traction over the years. As a high school student with a keen interest in the sciences, I have been particularly intrigued by the idea of drug replacement therapies. This essay delves into my exploration of this fascinating field, highlighting the potential benefits and the challenges associated with it.Drug replacement therapies, or what some refer to as alternative medicine, are treatments that are used in place of conventional pharmaceutical drugs. This approach can include a wide range of practices, from herbal remedies and acupuncture to homeopathy and chiropractic care. My journey into understanding this field began with a personal health issue that traditional medicine seemed to struggle with.I suffered from chronic headaches that were not effectively managed by the prescribed medications. The side effects were bothersome, and the relief was only temporary. It was then that I started to consider alternative options. I began researching various drug replacement therapies, and my first encounter was with acupuncture. This ancient Chinese practice involves the insertion of thin needles into specific points on the body to alleviate pain and treat various conditions.My experience with acupuncture was both enlightening and transformative. The practitioner explained that the therapy works on the principle of balancing the bodys energy flow, known as Qi. The process was surprisingly calming, and after several sessions, I noticed a significant reduction in the frequency and intensity of my headaches. This personalsuccess story sparked a deeper curiosity about the efficacy of alternative therapies.However, its important to note that the effectiveness of drug replacement therapies can be a contentious issue. While some studies suggest that certain alternative treatments can be as effective as, or even more effective than, traditional medications, others argue that the evidence is anecdotal and lacks scientific rigor. For instance, herbal remedies, which have been used for centuries in various cultures, are often touted for their healing properties. Yet, the regulation and standardization of these remedies can be inconsistent, leading to concerns about their safety and efficacy.Moreover, the integration of drug replacement therapies into mainstream healthcare is not without its challenges. There can be a lack of understanding and acceptance among medical professionals, who may not be trained in these alternative methods. Additionally, insurance coverage for such treatments can be limited, making them less accessible for many patients.Despite these hurdles, I believe that the potential benefits of drug replacement therapies are worth exploring further. For one, they can offer a more holistic approach to healthcare, taking into account the patients overall wellbeing rather than just addressing a specific symptom. Furthermore, for individuals like myself who have not found relief through conventional treatments, these alternatives can provide a new avenue for healing.In conclusion, my foray into drug replacement therapies has been an eyeopening experience. It has shown me that there is more to healthcare than just the pills and potions offered by conventional medicine. While it is crucial to approach these alternatives with a critical and informed perspective, I am optimistic about the role they can play in complementing traditional treatments and improving overall health outcomes. As a high school student, I am excited to continue learning about this field and perhaps one day contribute to the ongoing dialogue about the future of healthcare.。

急性重症胰腺炎诊治进展

急性重症胰腺炎诊治进展北京协和医院王春耀杜斌《中华急诊医学杂志》，2014,23（10）：1073-1075急性胰腺炎是胰腺的急性炎症反应，大约15%的患者进展为急性重症胰腺炎(SAP)，病死率可达13% [1]。

既往研究和临床经验表明，重症医学的诊疗措施对于改善急性重症胰腺炎患者的预后至关重要。

2010年以来，随着重症医学基础研究与临床实践的不断进步，一些新的临床指南相继出台，进一步规范了急性胰腺炎尤其是SAP的诊断、分级及治疗。

本文拟对此进行介绍。

1．急性胰腺炎的诊断与分级随着SAP病理生理学及其预后影响因素研究的不断深入，2012年召开的国际共识会议针对1992年亚特兰大分类标准进行了修订[2,3]。

在急性胰腺炎的临床诊断方面（表1），新标准基本延续了既往遵循的临床症状+酶学+影像学组合模式。

新的影像学技术（如核磁共振成像）的引进，丰富了急性胰腺炎的影像学诊断依据。

另外，新标准也注意到不同病因的急性胰腺炎在临床表现尤其是酶学改变方面的差异。

例如，酒精性胰腺炎患者胰淀粉酶和（或）脂肪酶的升高并不明显。

与1992年分类标准相比，新标准对胰腺炎严重程度的分级有了较大改变，即引入了中度胰腺炎(moderately severe pancreatitis)这一概念。

中度胰腺炎的定义为急性胰腺炎合并一过性（持续时间48小时以内）器官功能衰竭，或合并局部/系统并发症而无器官功能衰竭。

新标准采用改良Marshall评分定义器官功能障碍或衰竭（表2）。

与急性生理和慢性健康状况II评分(acute physiology and chronic health evaluation, APACHE II)相比，Marshall评分应用范围更广，可用于普通病房或急诊患者。

一项纳入163例急性胰腺炎患者的前瞻队列研究对于亚特兰大新分类标准与预后的关系进行了分析[4]。

结果显示，轻、中和重症患者入住ICU比例(4.6%vs. 43.1% vs. 83.3%)及平均ICU住院日（1.2 vs. 3.5 vs. 7.9日）随病情严重程度均显著增加。

211240336_感染性休克患者连续肾脏替代治疗中的容量管理

局解手术学杂志http ://2023,32（5）J REG ANAT OPER SURG 感染性休克患者连续肾脏替代治疗中的容量管理李洪超,蒋东坡,敬慧丹　（陆军特色医学中心野战外科研究所重症医学科,重庆 400042）［摘要］　感染性休克患者容易发生容量失衡，而容量失衡与重症患者器官受损和预后相关。

血液净化技术是感染性休克患者常用的治疗方法之一，连续肾脏替代治疗（CRRT ）可以实现目标滴定的容量管理模式，重建内环境稳态。

但血液净化治疗时，临床医生在管理中通常缺少动态评估和阶段性目标。

应关注感染性休克不同阶段的容量管理，全面评估容量等，最终通过CRRT 实现目标导向的容量管理。

［关键词］血液净化；连续肾脏替代治疗；休克；容量管理［中图分类号］ R459.5 ［文献标识码］ A ［收稿日期］ 2022-10-12Volume management in continuous renal replacement therapy in patients with septic shock LI Hong -chao ，JIANG Dong -po ，JING Hui -dan （Department of Intensive Care Unit ，Research Institute of Field Surgery ，ArmyMedical Center of PLA ，Chongqing 400042，China ）Abstract: Septic shock is prone to volume imbalance ，which is associated with organ damage and prognosis in severe patients.Bloodpurification technique is one of the commonly used treatment methods for patients with septic shock.Continuous renal replacement therapy（CRRT ） can achieve a volumetric management mode of target titration and rebuild homeostasis of internal environment.However ，during blood purification ，clinicians usually lack dynamic assessment and phased targets in management.By focusing on the volume management at different stages of septic shock ，comprehensively assessing volume ，and so on ，the ultimate goal oriented volume management can be achieved through CRRT.Keywords: blood purification ；continuous renal replacement therapy ；septic shock ；volume management感染性休克是院内重症患者最常见的休克类型，是疾病的危重症阶段，容易导致患者发生容量失衡，进而引起机体内环境紊乱。

CRRT的几个基本概念

Return Pressure Positive +50 to +150 mmHg
Effluent Pressure Negative or Positive >+50 to -150 mmHg
高通量旳滤器面积 1.6-2.2平方米
HVHF
总之，对重症脓毒血症或合并休克患者， CRRT极难设定上限计量，尚需研究，超滤
率至少应≥35ml/kg/h。
Access Pressure Negative -50 to -150 mmHg
Filter Pressure Positive +100 to +250 mmHg
凝措施）局部肝素抗凝法局部枸橼酸盐抗凝法低分子肝素抗凝法无肝素抗凝法前列腺素抗凝法
前列腺素抗凝法
原理：阻断血小板粘附功能和汇集功能有人以为比肝素安全，半衰期极短（2min) 缺陷：停用后抗血小板活性时间长（24H）无中和制剂调整需依赖血小板汇集试验药物剂量依赖性低血压发生率高应用
技术构成三
滤器聚砜膜（AV400及AV600）滤器聚丙烯腈膜（AN69）滤器
AN 69
AV600
血液滤过器旳构造
血液入口
透析液和滤出液出口
横断面
空心纤维膜
透析液入口
血液出口
空心纤维外面（滤出液）空心纤维里面（血液）
血滤器
种类
聚砜膜
聚丙烯晴膜
聚酰胺
膜通透性
低通量滤器 <10000D
治疗中旳经典压力
治疗中旳经典压力
动脉压Access Pressure
测量当血液离开病人血液通路(例如双腔导管)时旳压力(体外旳)

《中西医结合护理》2023年9卷7期封面-目录页-封底

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with five -element music therapy and nursing management of diarrhea in a patient with hemorrhagic stroke of Qi -deficiency and blood stasis syndrome …………LEI Xiaoyang ， CHEN Qing ， XU Shilai ， ZHANG Zhanwei ， ZHANG Qian ， DENG Haixia （34）Nursing of a patient with insomnia of heart -kidney disharmony treated by auricular acupoint pressing and acupoint finger -pressing therapy ………………………………………ZHANG Hui ， ZHOU Yunbo （38）Nursing of integrated traditional Chinese and western medicine for a patient with neurogenic bladder ………………………ZHENG Yingqian ， XU Jing ， ZOU Qiuyu （41）Traditional Chinese Medicine external treatment and nursing for a patient with recurrent fever in the sequelae of stroke with phlegm -heat stasis syndrome …………LUO Huanwen ， ZHOU Yunbo ， LIU Caidan （45）Nursing of a patient with acute cerebral infarction combined with lower gas⁃trointestinal tract bleeding ……………CHEN Haixiang ， WU Min （49）Psychological counseling and nursing interventions with Traditional Chi⁃nese Medicine characteristics for a patient with cluster headache………LIU Caidan ， YU Yanlan ， ZHOU Yunbo ， LUO Huanwen （54）Research progress of Traditional Chinese and Western medicine early reha⁃bilitation and its influencing factors in severe stroke patients…………………………………………LUO Hong ， YU Yanlan （58）Contents Responsible InstitutionBeijing Administration of Tradi⁃tional Chinese Medicine SponsorAssociation o f I ntegrative N ursingBeijing Traditional Chinese Med⁃icine Nursing Competence Im⁃provement Project OfficeEiditingEditorial Board of Chinese Jour⁃nal of Integrative Nursing Editor-in-ChiefTANG Ling DirectorHUANG Lei EditorsYIN Jiajie WU Yinping Editorial Assistant E Haiyan Art Editor WANG Li Address NO.155， Longpan Road ，Nanjing ， China Post Code 210037Tel + 86 - 25 - 85552880E⁃mail ： bjb@PublisherIntegrative Nursing Press Founder and CEO YE Zhenhua Tel + 86 - 25 - 85630967Online Publishinghttp ： / / E⁃mail ： tg@Academic DisseminationIntegrative Nursing （Nanjing ）Co.，LtdVolume 9Number 7July 2023Application progress of Traditional Chinese Medicine nursing technology in constipation after stroke ……………………………ZHANG Xi， CHEN Ouying， XU Shilai， ZHANG Zhanwei， LEI Xiaoyang （65）Progress of research on Traditional Chinese Medicine characteristic nursing of patients with cognitive impair⁃ment after stroke………………………………LI Wenya， XIAO Chun， HUANG Lu， PENG Xiaoling （71）Conception and prospect of talent training of Traditional Chinese Medicine encephalopathy nurse specialists …………………………………………………LIANG Xingxing， LI Huan， DENG Qian， HUANG Lu （78）Focusing on the integrated traditional Chinese and western medicine and building an innovative management model for chronic diseases in the elderly……………………………………………………YANG Mei （82）On the thinking of development trend of chronic disease management in the elderly……………YANG Mei （84）Effect of Traditional Chinese Medicine collapse stains combined with ultrasound drug penetration therapy in the treatment of diabetic peripheral neuropathy in the elderly………ZHANG Yuanlin， CAI Weiwei， LI Na （90）Effect of integrated traditional Chinese and western medicine in nursing of patients with allergic rhinitis …………………………………………………………………SUO Cuihong， YANG Mei， LIU Yunxia （95）Effect of cognitive impairment assessment on the incidence of hypoglycemia in hospitalized elderly patients with type 2 diabetes mellitus……………………………………………………………………LIU Yunxia （100）Influential factors and countermeasures of the difficulty in inserting peripheral inserted central venous catheter among elderly patients…………………………………………………………………………HE Ying （105）Effect of Traditional Chinese Medicine nursing combined with continuous nebulization in nursing of elderly pa⁃tients undergoing tracheostomy…………………………………………………………HUANG Ning （110）Application of Traditional Chinese Medicine nursing technology for elderly patients with advanced cancer ……………………………………………………………………………………………JIANG Shan （114）Effect of Traditional Chinese Medicine characteristic nursing technology combined with health education on gas⁃trointestinal adverse reactions during chemotherapy in elderly patients with cancer…………LI Fang （119）Effect of care bundles on the prevention of incontinence-associated dermatitis in the elderly…………………………………………………………LIU Yuhui， ZHANG Yaping， ZHENG Zhilan （123）Analysis of depression status and nursing interventions in 163 patients with liver disease……………………………………………WANG Yundan， WANG Weixian， HU Deying， LIU Yilan （126）Nursing of a patient with incomplete intestinal obstruction treated by the ultrasound-enhanced penetration of Tra⁃ditional Chinese Medicine………………………………………………………………………LIU Xu （133）Perioperative nursing of a patient undergoing total parathyroidectomy with subcutaneous autotransplantation for secondary hyperparathyroidism……………………………………………………………XIE Jihong （137）Nursing of a patient undergoing continuous renal replacement therapy for chronic renal failure …………………………………………………………………………………XU Juan， WANG Yaru （141）Auricular acupoint pressing therapy and nursing of a patient with insomnia after quitting smoking ……………………CAO Lei， KONG Xiaochun， LIU Yang， ZHANG Lijun， E Haiyan， TANG Ling （144）Auricular acupoint pressing and nursing of a patient with pneumonia and diabetes mellitus…HAN Jinghua （147）Application of fever triage system in emergency pre-examination and triage of COVID-19 patients ………………………………………………………………………………………………CHEN Xi （150）Influencing factors and nursing countermeasures of hypothermia in elder patients undergoing laparoscopic resec⁃tion of colon cancer………………………………………………………………………ZHU Yuehua （154）Review on the application of acupoint sticking therapy for constipation in adult patients………WANG Xiaomin， ZHENG Naihua， YANG Dongmei， E Haiyan， ZHANG Lijun， LIU Xiaoliu （158）Research progress on causes and nursing countermeasures of falls in elderly stroke patientsVolume 9Number 7July 2023………………………………………………………………………………MA Cuiqing， YANG Mei （164）An Evidence summary of postoperative pain management in spinal surgery…………………………………………………………XIANG Tingting， ZHENG Su， XIE Xiaomin （170）Discharge readiness and its influencing factors among pregnant women with gestational diabetes mellitus ……………………………………………………………DUAN Meimei， SUN Guiyu， LI Yuanyuan （176）A qualitative study on dietary distress of lung cancer patients during chemotherapy…………………………………………………………………………ZHANG Yueyu， YIN Yuanyuan （182）Application of stone needle ironing therapy in a patient with abdominal distension after surgery for lumbar spinal stenosis……………………………………………………………………………………ZHANG Xu （188）Nursing of a patient with deep muscle abscess after minimally invasive surgery for hepatic masses …………………………………………………………………………………………FENG Ruiping （191）Sherlock 3CGtip confirmation system for placement of peripherally inserted central catheters and related nursing countermeasures in a patient with double superior vena cava……………………………SONG Lanna， WANG Yuan， WANG Wenxuan， WANG Yu， ZHANG Na （195）Intracavitary electrocardiography for peripherally inserted central catheters tip location and nursing for a patient with persistent atrial fibrillation and acute left heart failure…………………LIAO Lihong， SHI Lihua （201）Application and nursing of prone ventilation technique in ICU………………………………………………DAI Hongran， WANG Huazhi， LI Yuhua， MA Haihong （205）Influence of enteral nutrition support via nasointestinal tube combined with fast-truck surgery on nutritional sta⁃tus， complications and postoperative rehabilitation of patients with severe head injury……LU Huixin （209）Effect of pelvic floor muscle training combined with hydrotherapy on postoperative rehabilitation of patients un⁃dergoing for sphincter preservation rectal cancer………………………HUANG Liming， WU Lifang （215）Establishment of chief nurse position in training and duty management of newly recruited nurses ……………………………………………………HE Dandan， ZHU Hengmei， YANG Lu， NI Yuan （219）Application of crisis management in patient complaint management in the pediatric dentistry clinic ……………………………………………………………………ZHOU Lina， LUO Sha， WANG Yan （224）Prone position ventilation and nursing management for a patient with influenza A （H1N1）virus infection com⁃bined with hypermucoviscous Klebsiella pneumoniae infection………………………………………WEI Xian， WANG Huiping， LIU Lu， LI Zhen， ZHANG Zhishu （229）Therapeutic effect of Ixekizumab combined with hemoperfusion in a patient with severe psoriasis ………………………………………………………………………LI Jing， SHEN Xia， LI Hongxian （234）Emergency care of a patient with ventricular arrhythmiastorms following acute myocardial infarction ……………………………………………………………………………………………WANG Biyun （237）Research progress in nursing of multiple myeloma complicated by peripheral neuropathy………………………………LI Lixia， BAN Jinchun， LIANG Jinglin， NONG Zhenzhen， WEI Ling （241）。

延长间断肾脏替代治疗非计划性下机相关因素分析

中国血液净化2020年1月第19卷第1期Chin J Blood Purif,January,2020,Vol.19,No.1·临床研究·延长间断肾脏替代治疗非计划性下机相关因素分析李雪洁1郑茜子1于重燕1金其庄1【摘要】目的探讨笔者中心实施延长间断肾脏替代治疗(prolonged intermittent renal re-placement therapy,PIRRT)非计划性下机的相关因素，对后续质量改进提供依据。

方法以2017年1月1日～12月31日由北京大学第一医院肾内科行PIRRT治疗的住院患者及其治疗例次作为研究对象，回顾性采集数据进行分析。

结果82例患者接受的898例次治疗最终纳入本研究，非计划性下机共259例次(28.8%)。

管路及滤器凝血共212例次，占非计划下机比例81.9%。

与计划性下机组相比，非计划性下机组无肝素抗凝比例更高(34.7%比13.3%，χ2=71.941，P＜0.001)，股静脉导管使用率(68.3%比59.8%，χ2=5.745，P=0.010)及最高滤过分数[(31.7±5.3)%比(31.0±4.6)%，t=-1.985，P=0.047]均更高。

2组间护士学历(62.9%比64.9%，χ2=0.304，P=0.318)、护士工作年限[(3.3±2.0)比(3.6±2.1)，t=-1.833，P=0.064]及患护比无显著差异[(1.8±0.7)比(1.9±0.8)，t=-0.971，P=0.360]。

结论抗凝方式选择不当、滤过分数设置过高及导管功能不良等导致循环管路及滤器凝血是笔者中心非计划性下机的主要原因。

在经过规范化培训和考核后，护士学历及工作年限对非计划性下机发生无显著影响。

【关键词】肾脏替代治疗；抗凝；滤过分数；回路寿命中图分类号：R318.16文献标识码：A doi:10.3969/j.issn.1671-4091.2020.01.002Related factors of unscheduled interruption during prolonged intermittent renal replacement therapyLI Xue-jie1,ZHENG Xi-zi1,YU Chong-yan1,JIN Qi-zhuang11Department of Nephrology,Peking Universi-ty First Hospital;Institute of Nephrology,Peking University;Key Laboratory of Renal Disease,China Minis-try of Health;Key Laboratory of Chronic Kidney Disease Prevention and Treatment,China Ministry of Educa-tion,Beijing100034,ChinaCorresponding author:JIN Qi-zhuang,Email:********************.cn【Abstract】Objective To explore the related factors of unscheduled interruption during prolonged inter-mittent renal replacement therapy(PIRRT).Method The medical records of all patients received PIRRT inthe Renal Department of Peking University First Hospital from January2017to December2017were retro-spectively reviewed.Circuit and patient data were collected and analyzed.Result A total of82patients with898circuits were finally included in this study,in which259circuits(28.8%)were considered as unscheduledinterruption.Circuit clotting was observed in212cases of the unscheduled interruption(81.9%).Compared tothe scheduled group,the unscheduled group was more likely not to receive anticoagulation(34.7%vs.13.3%,χ2=71.941,P<0.001),to use femoral vein catheters(68.3%vs.59.8%,χ2=5.745,P=0.010),and to have higherlevel of the highest filtration fraction(31.7±5.3%vs.31.0±4.6%,t=-1.985,P=0.047).There were no signifi-cant differences in the education degree of nurses(62.9%vs.64.9%,χ2=0.304,P=0.318),working years ofnurses(3.3±2.0vs.3.6±2.1,t=-0.971,P=0.064),and patient-nurse ratio(1.8±0.7vs.1.9±0.8,t=-1.833,P=0.360)between the two groups.Conclusion The main reason for unscheduled interruption during PIRRTin our dialysis center was circuit clotting caused by inappropriate use of anticoagulation,higher filtration frac-tion and catheter malfunction.After regular and standardized training,the education degree and working yearsof nurses had no significant impact on unscheduled interruption.【Key words】Renal replacement therapy;Anticoagulation;Filtration fraction;Circuit life延长间断肾脏替代治疗(prolongedintermit-tent renal replacement therapy,PIRRT)是血液净化的一种“杂合模式”，与连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)基金项目：北京大学第一医院科研种子基金(2019SF72)作者单位：100034北京，1北京大学第一医院肾内科，北京大学肾脏病研究所卫生部肾脏疾病重点实验室通讯作者：金其庄100034北京，1北京大学第一医院肾内科，北京大学肾脏病研究所卫生部肾脏疾病重点实验室Email：********************.cn ••3中国血液净化2020年1月第19卷第1期Chin J Blood Purif,January,2020,Vol.19,No.1相比，能减少抗凝需要，缩短治疗时间，降低成本,减少护士工作量，在重症患者治疗中应用亦较为广泛[1]。

血液透析及并发症

轻者头痛、恶心、呕吐、倦睡、烦躁不安、肌肉痉挛、视力模糊、血压升高；重者表现为癫痫发作、惊厥、木僵、甚至昏迷。
处理
根据病情给予50%葡萄糖或3%氯化钠10ml，也可输注白蛋白，必要时予镇静剂及其他对症治疗。
预防
初始透析应缩短透析时间，增加透析频率，透析过程中可适量提高钠浓度。
血液透析中常见的一些并发症或不良反应
空心纤维透析器：是目前最常用的透析器，由8000－15000根
中空纤维组成，纤维内径为200um，壁厚10um左右。其材料是半透膜，如铜仿膜、血仿膜、醋酸纤维膜、聚砜膜、聚丙烯晴膜等。血液在管中流动，这些中空纤维称为血室。外壳与血室之间间隙是透析液流动的地方称为水室。透析器长20-25cm，直径为5-10cm，透析面积为0.8-1.7m2，预冲血量为75-90ml。
血液透析中常见的一些并发症或不良反应
失衡综合征
是指在透析中、透析后期或结束后不久出现的与透析有关的以神经系统症状为主的一组综合征。
原因表现
血液透析时血液中的毒素迅速下降，血浆渗透压下降，而由于血脑屏障使脑脊液中的尿素等溶质下降较慢，以致脑脊液的渗透压相对较高，水分由血液进入脑脊液形成脑水肿。也与透析后脑脊液与血液之间的PH值梯度增大即脑脊液中PH值相对较低有关。
主要由体外循环系统、透析液配置供给系统及监控这两大系统的相关设备组成。
透析器
又称“人工肾”，透析过程中血液与透析液在透析器呈反向流动，溶质（毒素）和水的跨膜运转均在透析器中进行，透析膜是透析器的主要组成部分。
水处理系统
将自来水中的微粒、细菌、离子和微生物去掉，提供高纯度水供透析使用。
血液透析的适应症
其它急性药物或毒物中毒、难治性充血性心衰与急性肺水肿的急救、肝肾综合征、肝硬化顽固性腹水等。

血液透析讲课课件-2

IRRT
差峰谷式
每日透析3－4小时每日透析6－8小时
CRRT与IRRT的比较 (续)
• 足够的透析剂量超滤 1升/hr 2升/hr
3－4hr/日 6－8hr/日
用kt/v或Curea作指标，若达到CRRT的清除率，只有每日透析一次
CRRT是否降低了病人的死亡率？－尚无结论
* 缺乏严格的比照探讨 * 病情困难。MODS、败血症、自身防卫机制丢失、
反
心肺再循环
• 发生于透后2-3分钟 • 指通过静脉端回心血的一小部分，经过心
肺循环和动脉系统后，干脆进入滤器，而未经过含尿素丰富的组织。 • 当运用深静脉插管时，不存在。 • 占透后BUN反跳的15%。
影响透析充分的一些因素
• 透析处方不充分，发生于V过大的患者
– 体重>81kg
• 血管通路有问题
CRRT的优点
• 维持稳定的体重和循环血容量，从而避开 • 发生低血压和心排血量降低 • 代谢废物的清除量明显增加 • 水分的清除,特殊是在低血压患者中更为有效 • 维持肾灌注量促进肾功能复原
CRRT的指征
• 困难的急性肾衰
• 非肾衰病人
•
心血管不稳定 •
SIRS和败血症
•
严峻容量负荷过度•
ARDS
透后BUN反跳
• 血管通路再循环 • 心肺再循环
血管通路再循环
• 透析净化的血液逆向流向透析器的动脉端
• 可发生于动静脉内瘘或中心静脉置管 • 发生于透后数秒，占透后BUN反跳的50%
以上 • 血透停止，入口再循环即停止（20秒）
血管通路再循环
• 常见于 • 泵速>动脉血流速，内瘘血流不足 • 吻合口下游静脉狭窄，血流回流受阻 • 动静脉穿刺点距离：>10cm • 透析管路的反向运用

药物替代疗法英语作文

药物替代疗法英语作文Title: The Advantages of Drug Replacement Therapy。

Drug replacement therapy, also known as medication substitution therapy, is a revolutionary approach in the medical field that offers an alternative to traditional pharmaceutical treatments. This therapeutic method involves substituting a conventional medication with a differentdrug or therapy to achieve similar or even superior therapeutic effects. In this essay, we will delve into the merits of drug replacement therapy and explore its impacton modern healthcare.First and foremost, drug replacement therapy presents a promising solution to the issue of medication resistance. Over time, patients may develop resistance to certain drugs, rendering them ineffective in treating their medical conditions. By substituting these medications with alternative drugs or therapies, healthcare professionalscan overcome this challenge and provide patients witheffective treatment options. This approach is particularly beneficial in the management of chronic diseases such asHIV/AIDS, tuberculosis, and malaria, where drug resistanceis a prevalent concern.Furthermore, drug replacement therapy offers a more personalized approach to patient care. Each individual responds differently to medications due to factors such as genetic makeup, metabolism, and coexisting medical conditions. Therefore, tailoring treatment regimens to suit the specific needs of each patient is essential for optimizing therapeutic outcomes. Drug replacement therapy allows healthcare providers to customize treatment plans based on the patient's unique characteristics, thereby improving treatment efficacy and patient satisfaction.Moreover, drug replacement therapy can mitigate adverse drug reactions and side effects. Many conventional medications are associated with undesirable side effectsthat can significantly impact the patient's quality of life. By replacing these drugs with alternative therapies that have a more favorable side effect profile, healthcareprofessionals can minimize patient discomfort and enhance treatment adherence. This is particularly beneficial for elderly patients and individuals with multiple comorbidities who are more susceptible to adverse drug reactions.Additionally, drug replacement therapy can address the issue of medication cost and accessibility. In many parts of the world, access to essential medications is limited due to factors such as high drug prices and inadequate healthcare infrastructure. Drug replacement therapy provides a cost-effective alternative to expensive pharmaceuticals, making essential treatments more accessible to underserved populations. By utilizing lower-cost medications or non-pharmacological therapies, healthcare providers can ensure that patients receive the care they need without financial burden.Furthermore, drug replacement therapy promotes innovation and advances in medical research. By exploring alternative treatment modalities, researchers can discover new drugs, therapies, and treatment approaches that mayoffer superior efficacy and safety compared to existing medications. This fosters a culture of innovation within the medical community and drives progress in the field of healthcare.In conclusion, drug replacement therapy holds immense potential in revolutionizing modern healthcare by offering alternative treatment options that are personalized, effective, and affordable. By harnessing the benefits of this therapeutic approach, healthcare providers can improve patient outcomes, minimize adverse drug reactions, and enhance the overall quality of care. As we continue to explore the possibilities of drug replacement therapy, it is evident that this approach will play a pivotal role in shaping the future of medicine.。

药物替代疗法英语作文高中

药物替代疗法英语作文高中Title: Alternative Medicine: A Controversial Approach。

Introduction:Alternative medicine, also known as complementary or integrative medicine, has gained significant attention in recent years as a substitute for conventional medical treatments. While some advocate for its effectiveness and holistic approach, others remain skeptical due to the lack of scientific evidence and potential risks associated with certain practices. This essay delves into the controversial topic of alternative medicine, examining its principles, benefits, drawbacks, and the need for a balanced perspective.Body:I. Understanding Alternative Medicine。

A. Definition and Scope。

1. Definition of alternative medicine。

2. Various forms and practices: acupuncture, herbal medicine, chiropractic care, etc.B. Principles and Philosophy。

超短波治疗仪联合呼吸锻炼预防重症急性肾损伤CRRT_患者肺部感染的效果

超短波治疗仪联合呼吸锻炼预防重症急性肾损伤CRRT患者肺部感染的效果吴姗姗① 【摘要】　目的：分析重症急性肾损伤连续性肾脏替代治疗（CRRT）患者采用超短波治疗仪联合呼吸锻炼对肺部感染的预防效果。

方法：采取前瞻性随机对照研究，选取2020年1月—2022年6月抚州市第一人民医院收治的102例重症急性肾损伤CRRT患者作为研究对象，采用随机数字表法分为对照组和观察组，各51例。

两组均给予常规护理干预，在此基础上，对照组采取呼吸锻炼干预，观察组采用超短波治疗仪联合呼吸锻炼干预，两组均干预4周。

统计并比较两组干预期间肺部感染发生率及日排痰量、干预前及干预4周时生活质量[健康调查简表（SF-36）]、对护理工作的满意度。

结果：观察组肺部感染发生率低于对照组，日排痰量多于对照组（P<0.05）。

干预4周，两组SF-36中情感职能、精神健康、躯体疼痛、生命活力、生理功能、生理职能、社会功能、总体健康维度评分均高于干预前，且观察组均高于对照组（P<0.05）；观察组护理满意度中健康宣教、护理环境、护理服务流程、医嘱执行方面评分均高于对照组（P<0.05）。

结论：超短波治疗仪联合呼吸锻炼预防重症急性肾损伤CRRT患者肺部感染的效果较好，可促进重症急性肾损伤患者排痰，降低肺部感染发生率，提高患者生活质量及护理满意度。

【关键词】　重症急性肾损伤　连续性肾脏替代治疗　肺部感染　超短波治疗仪　呼吸锻炼 Effect of Ultrashort Wave Therapeutic Apparatus Combined with Respiratory Exercise on Preventionof Pulmonary Infection in Patients with Severe Acute Kidney Injury Undergoing CRRT/WU Shanshan. //Medical Innovation of China, 2023, 20(33): 117-121 [Abstract]　Objective: To analyze the preventive effect of ultrashort wave therapeutic apparatus combinedwith respiratory exercise on pulmonary infection in patients with severe acute kidney injury undergoing continuousrenal replacement therapy (CRRT). Method: A prospective randomized controlled study was conducted. A total of102 patients with severe acute kidney injury treated with CRRT in First People's Hospital of Fuzhou from January2020 to June 2022 were selected as the study objects. According to the random number table method, they weredivided into the control group and the observation group, with 51 cases in each group. Both groups were given routinenursing intervention, on this basis, the control group was given respiratory exercise intervention, and the observationgroup was given ultrashort wave therapy combined with respiratory exercise intervention. Both groups wereintervened for 4 weeks. The incidence of pulmonary infection and the daily sputum output during the intervention,quality of life [short form health survey (SF-36)] before the intervention and 4 weeks after the intervention andsatisfaction with nursing work were recorded and compared between the two groups. Result: The incidence ofpulmonary infection in the observation group was lower than that in the control group, and the daily sputum outputwas more than that in the control group (P<0.05). After 4 weeks of intervention, the scores of emotional function,mental health, bodily pain, vitality, physiological function, role-physical, social function and overall healthdimensions of SF-36 in the two groups were higher than those before intervention, and those in the observation groupwere higher than those in the control group (P<0.05); the scores of nursing satisfaction scores of health education,nursing environment, nursing service process and doctor's advice execution in the observation group were higherthan those in the control group (P<0.05). Conclusion: The ultrashort wave therapeutic apparatus combined withrespiratory exercise has a good effect in preventing pulmonary infection in patients with severe acute kidney injurytreated with CRRT. It can promote sputum output in patients with severe acute kidney injury, reduce the incidence ofpulmonary infection, and improve the quality of life and nursing satisfaction of patients. [Key words]　Severe acute kidney injury　Continuous renal replacement therapy　Pulmonary infection　①江西省抚州市第一人民医院　江西　抚州　344000通信作者：吴姗姗- 117 - 连续性肾脏替代治疗（continuous renal replacement therapy，CRRT）是治疗重症急性肾损伤的有效方式之一，可更好的清除炎症递质和代谢废物，有利于肾功能恢复、降低病死率[1]。

激素替代疗法在罕见病患者中的效果评估

激素替代疗法在罕见病患者中的效果评估激素替代疗法（Hormone Replacement Therapy，HRT）是一种常见的治疗方法，用于补充或替代身体缺乏的激素。

在一些罕见病患者中，由于遗传或其他原因，身体无法正常产生或利用某些激素，导致一系列症状和健康问题。

激素替代疗法通过补充缺乏的激素，可以改善患者的生活质量和健康状况。

本文将对激素替代疗法在罕见病患者中的效果进行评估。

一、激素替代疗法的原理和适应症激素替代疗法的原理是通过给予患者身体缺乏的激素，以达到恢复正常生理功能的目的。

激素替代疗法可以应用于多种罕见病，如甲状腺功能减退症、肾上腺皮质功能减退症、性腺功能减退症等。

这些疾病导致患者体内激素水平异常，从而引发一系列症状，如疲劳、性功能障碍、骨质疏松等。

激素替代疗法可以通过补充缺乏的激素，改善这些症状，提高患者的生活质量。

二、激素替代疗法的效果评估方法评估激素替代疗法在罕见病患者中的效果需要综合考虑多个方面的指标。

以下是常用的评估方法：1. 生理指标评估：通过检测患者体内激素水平的变化，评估激素替代疗法的效果。

例如，对于甲状腺功能减退症患者，可以通过检测甲状腺激素TSH、T3、T4的水平来评估治疗效果。

2. 症状评估：通过询问患者自身感受和观察症状的变化，评估激素替代疗法对症状的改善程度。

例如，对于性腺功能减退症患者，可以询问患者性欲、勃起功能等方面的改善情况。

3. 生活质量评估：通过使用生活质量问卷，评估激素替代疗法对患者生活质量的影响。

生活质量问卷包括身体功能、心理健康、社交功能等多个方面的评估指标。

4. 骨密度评估：对于一些罕见病患者，如肾上腺皮质功能减退症患者，骨质疏松是常见的并发症。

通过检测骨密度的变化，评估激素替代疗法对骨质疏松的预防和治疗效果。

三、激素替代疗法的优势和风险激素替代疗法在罕见病患者中具有一定的优势，但也存在一些风险。

1. 优势：激素替代疗法可以有效改善患者的症状，提高生活质量。

药物替代疗法英语作文

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Alternative medicine is becoming increasingly popular as people seek natural and holistic approaches to healthcare. From acupuncture to herbal remedies, there are a wide range of alternative therapies available.One popular alternative therapy is acupuncture. This ancient Chinese practice involves inserting thin needles into specific points on the body to stimulate energy flow and promote healing. Many people find acupuncture to be effective in relieving pain and reducing stress.Another alternative therapy is herbal medicine. Instead of relying on synthetic drugs, herbal remedies use plants and plant extracts to treat various ailments. For example, chamomile tea is often used as a natural remedy for insomnia, while ginger can help alleviate nausea and indigestion.Homeopathy is another form of alternative medicine that is gaining popularity. Homeopathic remedies are made from highly diluted substances and are believed to stimulate the body's own healing mechanisms. While some people swear by homeopathy, others are skeptical of its effectiveness.Meditation and yoga are also considered alternative therapies. These practices focus on calming the mind and promoting relaxation. Many people find that regular meditation or yoga sessions help reduce stress, improve concentration, and enhance overall well-being.In addition to these therapies, there are also alternative approaches to mental health. For example, cognitive behavioral therapy (CBT) is a form of talk therapy that helps individuals identify and change negative thought patterns. CBT is often used to treat anxiety and depression.Overall, alternative medicine offers a diverse range of therapies that can complement traditional medicaltreatments. While some people may find relief in these alternative approaches, it's important to remember that they may not work for everyone. It's always best to consult with a healthcare professional before trying any new therapy or treatment.。

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