治疗性血交换在美国的住院使用:2016-2021年
Jianling Tao1, Sijie Zheng2, Lusilda Agolli3
1Division of Nephrology, Department of Medicine, Stanford University School of Medicine, CA.
Kidney medicine
|November 10, 2025
概括
治疗性血交换 (TPE) 治疗各种自身免疫和炎症性疾病. 这项研究发现,TPE使用量从2016年至2021年增加,符合指南,但与更高的医院费用有关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 神经学 神经学
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 临界护理医学 临界护理医学
背景情况:
- 治疗性血交换 (TPE) 是许多自身免疫,炎症,血液和代谢疾病的关键治疗方法.
- 了解美国目前的住院TPE利用模式对于临床实践和资源配置至关重要.
研究的目的:
- 描述2016年至2021年美国TPE住院患者使用的当代范围.
- 确定使用TPE治疗的最常见疾病,并分析相关的患者和医院特征.
- 评估TPE对医院成本的影响.
主要方法:
- 一项采用2016年至2021年国家住院患者样本 (NIS) 数据的横截面研究.
- 分析包括权重数据以反映国家估计,并考虑复杂的调查设计对所有分析.
- 描述了人口统计,并发病症,医院特征,成本以及使用TPE治疗的特定临床疾病.
主要成果:
- 超过106,000次住院治疗涉及TPE (占总数的0.051%).
- 最常见的疾病包括严重肌痛性肌痛 (9.53%),吉林巴雷综合征 (6.19%) 和血栓性微血管病变 (6.18%).
- TPE的使用与显著更高的住院费用 (OR 3.47-11.07) 有关,并与美国非学会的指导方针保持一致.
结论:
- 治疗性血交换仍然是严重的自身免疫和炎症性疾病的重要治疗方法.
- 目前TPE的使用符合已建立的临床实践指南.
- TPE与增加的医院费用有关,强调需要仔细考虑其应用.
相关概念视频
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy
166
Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in...
166
Extracorporeal Removal of Drugs: Hemoperfusion and Hemofiltration
184
Hemoperfusion and hemofiltration are critical techniques in medical treatments to eliminate accumulated drugs, metabolites, and electrolytes from the bloodstream. These methods are particularly vital in cases of accidental poisoning and drug overdose.Hemoperfusion involves passing blood through an adsorbent material to remove unwanted substances. The main adsorbents used in hemoperfusion include activated charcoal and Amberlite resins. Activated charcoal can adsorb both polar and nonpolar...
184
Extracorporeal Removal of Drugs: Peritoneal Dialysis and Hemodialysis
379
Patients with end-stage renal disease (ESRD) or those experiencing drug overdose often require extracorporeal methods to eliminate accumulated drugs and metabolites. Hemoperfusion, hemofiltration, and dialysis are the primary techniques to rapidly remove harmful substances without disrupting the patient's fluid and electrolyte balance. For those with compromised renal function, dosage adjustments of concurrent medications may be necessary during extracorporeal drug removal.Dialysis is a process...
379
Continuous Renal Replacement Therapy
783
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
783
Drug Distribution: Plasma Protein Binding
8.3K
Drugs predominantly attach to plasma proteins, with only a small percentage remaining unbound. The unbound portion can be calculated as one minus the bound fraction. Acidic drugs form large, inactive complexes by reversibly binding to plasma albumin, which prevents them from diffusing across biological barriers. These drug-protein complexes act as reservoirs for the drugs. As the concentration of unbound drugs decreases, these complexes quickly dissociate to release the free drug, maintaining...
8.3K
Issues And Trends In Healthcare Delivery System
6.1K
The issues and trends in healthcare delivery are constantly changing. The COVID-19 pandemic is one recent issue that wreaked havoc on healthcare systems, causing a shortage of healthcare workers, high demand for medicines and supplies, and increased medical expenditure due to a lack of insurance. Other issues include rising healthcare costs and care fragmentation.
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
Cost Containment
Payment for healthcare services has historically promoted adoption of costly and often unnecessary or inefficient...
6.1K


