水分置換療法

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水分置換療法 Aquapheresis
ICD-9	99.78

水分置換療法（aquapheresis、置換治療），旨在從一位患有高血容量症(hypervolemia/fluid overload)病徵的患者身體以安全地，可以預見地，並有效地移除多餘的鹽及水的一種保健醫療技術(Health technology)。

水分置換療法移除患者身體上多餘的鹽和水分，並幫助患者恢復的適當的液體平衡(fluid balance/流體平衡)、此即所謂的〈等量體液維持法(euvolemia)〉。

用途

参见：膠體滲透壓

水分置換療法用於治療一種名為"液體超負荷(流體過載)"和"高血容量症(Hypervolemia)"病徵的療法。液體超負荷可以由許多原因，包括心臟衰竭、肝硬化，高血壓和某些腎病變等疾病所引起的。液體超負荷也可以產生於某些外科手術後的預後情況。充血性心臟衰竭是液體超負荷的最常見原因。

運行機制

• 通過一個特殊的過濾器、使用外週或中央靜脈導管(Catheter)抽出患者含有過量鹽和水的血液。使用一種超滤的形式，該過濾器從血液中分離過量的鹽和水。而這些流體(過量的鹽和水)被收集在一個袋子裡以便之後進行處理，接著將血液再輸送回至患者。
• 抗凝血治療常與水分置換療法一起使用於防止血液在超濾過濾器上凝固。
• 血液不到一分鐘的時間流到體外、且血液流出的總量為33毫升（2.5湯匙）。因此，這是一種體外治療。
• 最多每小時可除去過量的流體500毫升(1品脫)。平均去除率為每小時250毫升（1/2品脫）。
• 水分置換療法由三個基本部分組成：一座控制台（具有兩個泵浦）、血液過濾電路，以及靜脈導管。

註釋

• Costanzo MR, Guglin ME, Saltzberg MT, et al. Ultrafiltration versus intravenous diuretics for patients hospitalized for acute decompensated heart failure. J Am Coll Cardiol. Feb 2007, 49 (6): 675–83. PMID 17291932. doi:10.1016/j.jacc.2006.07.073. 
• Costanzo MR, Guglin ME, Saltzberg MT, et al. Ultrafiltration is Associated With Fewer Rehospitalizations than Continuous Diuretic Infusion in Patients With Decompensated Heart Failure: Results From UNLOAD. J Card Fail. 2010, 16 (4): 277–84. PMID 20350693. doi:10.1016/j.cardfail.2009.12.009. 
• Costanzo MR, Saltzberg M, O'Sullivan J, Sobotka P. Early ultrafiltration in patients with decompensated heart failure and diuretic resistance. J Am Coll Cardiol. Dec 2005, 46 (11): 2047–51. PMID 16325040. doi:10.1016/j.jacc.2005.05.099. 
• Bart BA, Boyle A, Bank AJ, et al. Ultrafiltration versus usual care for hospitalized patients with heart failure: the Relief for Acutely Fluid-Overloaded Patients With Decompensated Congestive Heart Failure (RAPID-CHF) trial. J Am Coll Cardiol. Dec 2005, 46 (11): 2043–6. PMID 16325039. doi:10.1016/j.jacc.2005.05.098. 
• Jaski BE, Ha J, Denys BG, Lamba S, Trupp RJ, Abraham WT. Peripherally inserted veno-venous ultrafiltration for rapid treatment of volume overloaded patients. Journal of Cardiac Failure. Jun 2003, 9 (3): 227–31. PMID 12815573. doi:10.1054/jcaf.2003.28. 
• Marenzi G, Lauri G, Grazi M, Assanelli E, Campodonico J, Agostoni P. Circulatory response to fluid overload removal by extracorporeal ultrafiltration in refractory congestive heart failure. J Am Coll Cardiol. Oct 2001, 38 (4): 963–8 [2016-08-01]. PMID 11583865. doi:10.1016/S0735-1097(01)01479-6. （原始内容存档于2019-06-06）. 
• Agostoni P, Marenzi G, Lauri G, et al. Sustained improvement in functional capacity after removal of body fluid with isolated ultrafiltration in chronic cardiac insufficiency: failure of furosemide to provide the same result. Am J Med. Mar 1994, 96 (3): 191–9. PMID 8154506. doi:10.1016/0002-9343(94)90142-2. 
• Pepi M, Marenzi GC, Agostoni PG, et al. Sustained cardiac diastolic changes elicited by ultrafiltration in patients with moderate congestive heart failure: pathophysiological correlates. Br Heart J. Aug 1993, 70 (2): 135–40. PMC 1025273 . PMID 8038023. doi:10.1136/hrt.70.2.135. 
• Agostoni PG, Marenzi GC, Pepi M, et al. Isolated ultrafiltration in moderate congestive heart failure. J Am Coll Cardiol. Feb 1993, 21 (2): 424–31. PMID 8426008. doi:10.1016/0735-1097(93)90685-T. 
• S. A. Hunt; W. T. Abraham; M. H. Chin; A. M. Feldman; G. S. Francis; T. G. Ganiats; M. Jessup; M. A. Konstam; D. M. Mancini; et al. 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: A Report of the American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines: Developed in Collaboration With the International Society for Heart and Lung Transplantation. Circulation. 2009, 119 (14): e391–e479 [2016-08-01]. PMID 19324966. doi:10.1161/CIRCULATIONAHA.109.192065. （原始内容存档于2009-05-03）. 
• Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, Klapholz M, Moser DK, Rogers JG, Starling RC, Stevenson WG, Tang WH, Teerlink JR, Walsh MN. Executive Summary: HFSA 2010 Comprehensive Heart Failure Practice Guideline. J Card Fail. 2010, 16 (6): 475–539 [2016-08-01]. PMID 20610207. doi:10.1016/j.cardfail.2010.04.005. （原始内容存档于2016-10-21）. 
• Kenneth Dickstein; Alain Cohen-Solal; Gerasimos Filippatos; John J.V. McMurray; Piotr Ponikowski; Philip Alexander Poole-Wilson; Anna Stromberg; Dirk J. van Veldhuisen; Dan Atar; Arno W. Hoes; Andre Keren; Alexandre Mebazaa; Markku Nieminen; Silvia Giuliana Priori; Karl Swedberg. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure (PDF). Eur Heart J. 2008, 29 (10): 2388–2442 [2016-08-01]. PMID 18826876. doi:10.1016/j.ejheart.2008.08.005. （原始内容 (PDF)存档于2011-07-26）. 
• JG Howlett; RS McKelvie; JMO Arnold; et al. Canadian Cardiovascular Society Consensus Conference guidelines on heart failure, update 2009: Diagnosis and management of right-sided heart failure, myocarditis, device therapy and recent important clinical trials (PDF). Can J Cardiol. 2009, 25 (2): 85–105 [2016-08-01]. PMC 2691911 . PMID 19214293. doi:10.1016/S0828-282X(09)70477-5. （原始内容 (PDF)存档于2011-07-06）. 

參閱

• 液體平衡(Fluid balance)
• 利尿劑
• 血液分離置換療法(Apheresis)
• 心臟衰竭
• 高血容量症(Hypervolemia/液體超負荷/Fluid overload)
• 腎超濾作用(Ultrafiltration (renal))
• 超滤

外部連結

• The UNLOAD Study: Ultrafiltration Versus Intravenous Diuretics for Patients Hospitalized for Acute Decompensated Heart Failure. http://www.unloadstudy.com（页面存档备份，存于互联网档案馆）
• Google Search on Aquapheresis: http://www.google.com/search?hl=en&q=aquapheresis