中文摘要：

目的探讨持续低效每日透析（sustainedlow-efficiencydailydialysis，SLEDD）治疗肾移植术后移植肾功能延迟恢复（delayedgraftfunction，DGF）的疗效。方法选择2011年6月至2016年3月西安交通大学第一附属医院肾移植科78例同种异体尸体肾移植术后发生DGF且需行肾脏替代治疗的患者。其中采用间断性血液透析（intermittenthemodialysis，IHD）治疗22例，采用SLEDD治疗32例，采用持续静脉．静液滤过（continuousveno-venoushemofiltration，CVVH）治疗24例，三组治疗前临床资料比较差异无统计学意义（P〉0．05）。回顾性分析三种血液净化治疗模式对DGF患者尿毒症毒素浓度变化、血流动力学、水一电解质和酸碱平衡、疾病转归指标及所需血液净化时间、费用的影响。结果三组患者每次治疗后尿毒症毒素平均浓度变化IHD组高于SLEDD及CVVH组（P〈0．01），血流动力学不稳定的发生率IHD组高于SLEDD及CVVH组（P〈0．05），每日液体出入量、超滤量SLEDD及CVVH组均较IHD组增多（P〈0．05），肾功能恢复率SLEDD及CVVH组优于IHD组（P〈0．05），移植。肾功能恢复时间SLEDD及CVVH组明显短于IHD组（P〈0．05），SLEDD与CVVH组比较差异无统计学意义（P〉0．05）。电解质及酸碱平衡指标三组间差异无统计学意义（P〉0．05）；血液净化治疗费用CVVH组明显高于IHD及SLEDD组（P〈0．05），IHD组与SLEDD组无明显差别（P〉0．05）。结论SLEDD在DGF治疗中，与IHD比较，患者血流动力学相对稳定，移植。肾功能恢复率高、恢复时间短，并有相对较大的液体摄入空间；与CVVH比较，尿毒症毒素浓度变化、血流动力学、移植肾功能恢复率及恢复时间无明显差异，但血液净化治疗所需时间及费用相对较少。

英文摘要：

Objective To observe the effect of sustained low-efficiency daily dialysis （SLEDD） in recipients with delayed graft function （DGF） after kidney transplantation. Methods A total of 78 cases of kidney transplant patients with DGF were selected from the Department of Renal Transplantation of the First Affiliated Hospital of Xi＇an Jiaotong University from June 2011 to March 2016. 22 cases were treated with intermittent hemodialysis （IHD）, 32 cases were treated with SLEDD and 24 cases were treated with continuous veno-venous hemofiltration （CWH） randomly in other 56 cases. No statistical difference was found in the clinical data of the three groups（ P 〉 0.05）. Data of uremic toxin＇ sclearance, hemedynamics,water-electrolyte and acid-base balance, disease outcome indicators, time and cost of blood purification were analyzed retrospectively. Results The average uremia toxin＇ s concentration changes per treatment of IHD group were more significant than those of SLEDD and CVVH groups （ P 〈 0.01 ）, the incidence rates of hemodynamic instability in IHD group were higher than that in SLEDD and CVVH groups （ P 〈 0.05 ）, the daily fluid intake and ultrafiltration volume of SLEDD and CVVH groups were more than that of IHD group （ P 〈 0.05）, the renal function recovery rates of SLEDD and CVVH groups were better than that of IHD group （ P 〈 0.05 ）, the graft function recovery time of SLEDD and CVVH groups was shorter than that of IHD group （ P 〈 0.05）, and no statistically difference between SLEDD and CVVH groups about all the above indicators （ P 〉 0.05 ）. Electrolyte and acid-base indicators of the three groups were no statistical significance（ P 〉 0.05）. The expenses of blood purification of CVVH group were significantly higher than those of IHD and SLEDD group （P 〈 0.05）, and no obvious difference between SLEDD and CVVH groups （P 〉 0.05）. Conclusions Compared with IHD therapy, SLEDD treatment in DGF patients could reach higher hemodynamic instab