摘要
目的探讨联机血浆钠浓度监测的准确性,观察个体化低钠透析模式对患者水钠平衡、血压的影响及透析过程中不良反应。方法选择40例维持性血液透析患者,联机血钠监测及生化法测得血钠浓度对比,并对每例患者各行标准钠透析及个体化低钠血液透析。对两种透析模式透析前后血浆钠浓度等临床指标及不良反应进行比较。结果 40例患者行标准钠透析中联机血钠监测测定血浆钠浓度进行比较。测得联机血钠浓度138±3mmol/L,自动生化分析仪法血浆钠浓度为138.0±2.8mmol/L,2者比较差异无统计学意义(P=0.06)。将2种方法测量值作散点图,2者呈直线相关。两者的直线回归相关指数r=0.823,r2=0.677,回归系数t值为4.309,P<0.001。个体化低钠透析模式血钠浓度、收缩压(153.94±22.02mmHg和148.07±21.23mmHg,P=0.013)、口渴程度(54例次与98例次,P<0.001)均明显降低,不良事件发生率低。结论联机血钠监测测得的血钠浓度与常规生化分析结果相关性好;个体化低钠透析模式能明显降低透后血钠浓度、收缩压、口渴程度及透析期间体质量增长,不良事件发生率低,安全性好。
Objective The aim of the study was to observe the accuracy of online monitoring serum sodi- um concentration and the effect of individualized low-sodium dialysis mode on water and sodium balance and blood pressure and its adverse reactions in hemodialysis patients. Method We studied 40 maintenance he- modialysis patients in the period from March 2013 to May 2013 in our unit. Patients were treated with indi- vidualized low-sodium dialysis after dialysis with the dialysate containing standard sodium. Clinical indexs including serum sodium concentration and adverse reactions were compared between the two dialysis modes. Results There was no statistical difference in serum sodium concentration obtained by online monitoring and biochemical methods. Compared with the standard sodium dialysis, serum sodium, systolic blood pressure and thirst degree were significantly reduced with lower incidence of adverse events in patients using individu- alized low-sodium dialysis mode. Conclusion There was a close correlation in serum sodium concentrations using online monitoring and conventional biochemical methods. Serum sodium level, systolic blood pressure, thirst degree, and interdialytic weight gain could be properly controlled in patients using individualized lowsodium dialysis mode, a mode with higher safety and lower incidence of adverse events.
出处
《中国血液净化》
2013年第8期432-434,454,共4页
Chinese Journal of Blood Purification
关键词
个体化低钠透析模式
联机血钠监测
血钠浓度
Individualized low-sodium dialysis mode
Online monitoring serum sodium concentra-tion
Serum sodium concentration
