摘要
目的探讨不同透析方法预防血液透析中低血压反应的效果。方法选取76例于2016年2月—2017年1月在我院行维持性血液透析治疗且反复发生低血压反应的患者为研究对象,采取随机数字表法将所有患者分为对照组和观察组;对照组按照常规透析法实施操作,观察组行指数衰减透析液钠浓度和超滤速度透析法。观察并比较两组患者透析情况、透析后的血压情况及低血压发生情况。结果观察组患者的相对血容量下降值(△BV)、红细胞比容(HCT)的增加值均明显低于对照组(P<0.001或P<0.01),而脱水量、尿素氮下降率(URR)明显高于对照组(P<0.05),两组透析后血钠水平比较差异无统计学意义(P>0.05);观察组透析后的收缩压、舒张压及平均动脉压较对照组均明显升高,差异具有统计学意义(P<0.05);观察组低血压的发生率明显低于对照组(P<0.001)。结论血液透析时,采取指数衰减透析液钠浓度和超滤速度透析法实施透析操作,可以有效地减少低血压和并发症的发生,提高患者的耐受性,应当在临床上进一步地推行和应用。
Objective To investigate the effects of different dialysis methods on prevention of hypotension in hemodialysis patients. Methods Seventy-six patients who underwent maintenance hemodialysis in our hospital from February 2016 to January 2017 and who had recurrent hypotension were enrolled in this study.The patients were divided into a control group and an observation group by using a random number table method.Patients of the control group were given conventional dialysis operation,and patients of the observation group received exponential decay dialysate sodium concentration and ultrafiltration speed dialysis.The dialysis outcomes,post-dialysis blood pressure and hypotension incidence were observed and compared between the two groups. Results The reduction value of relative blood volume（△BV）and the increase value of hematocrit（HCT）in the observation group were significantly lower than those in the control group（P〈0.001 or P〈0.01）,and the dehydration volume and urea reduction rate（URR）were significantly higher than those in the control group（P〈0.05）.Comparison of the post-dialysis blood sodium level of the observation group with the control group showed that there was no statistically significant difference（P〈0.05）.The post-dialysis systolic blood pressure,diastolic blood pressure and mean arterial pressure in the observation group were significantly higher than those in the control group,comparison of the observation group with the control group showed that there were statistically significant differences（P〈0.05）.The observation group had lower incidence of hypotension than the control group（P〈0.001）. Conclusion During hemodialysis,using the exponential decay dialysate sodium concentration and ultrafiltration speed dialysis operation can effectively reduce the incidence of hypotension and complications,and can improve patient tolerance,which should be further promoted in the clinical application.
出处
《右江民族医学院学报》
2017年第6期475-477,共3页
Journal of Youjiang Medical University for Nationalities
关键词
血液透析
低血压
指数衰减透析液钠浓度和超滤速度透析法
常规透析法
hemodialysisl hypotension
exponential decay dialysate sodium concentration and ultrafiltra-tion speed dialysis
conventional dialysis
