在线血容量监测对调整血透析患者干体重的应用研究  

The application of measurement of blood volume on line to modulate dry weight during hemodialysis

作　　者：梁莉[1] 初继庆[1] 

机构地区：[1]第三军医大学新桥医院,重庆400037

出　　处：《医疗设备信息》2005年第11期62-64,共3页Information of Medical Equipment

摘　　要：目的了解在线血容量(blood volume,BV)监测对调整血液透析患者干体重(drv weight,DW)以及防治透析中低血压及药物依赖高血压的作用.方法49例维持性血液透析患者共进行108例次透析在线BV监测,其中男29例,女20例,年龄27～54岁,平均年龄47岁.根据患者透析中表现分为低血压组(A组,n=31)和高血压组(B组,n=18),观察所有患者透析前后血压、体重、超滤量、BV变化及临床表现.结果根据透析中BV变化曲线及临床表现上调A组患者DW1.53±0.71kg,透析结束时BV下降率(△BV)明显升高(16.06%±2.03%vs.21.03%±1.99%,p＜0.05),未再发生低血压.对B组下调DW,每次0.5kg,DW共降低2.48±0.62kg,透析结束时△BV明显下降(11.5%±0.61%vs.4.36%±0.37%,p＜0.05),高血压得以较好控制.结论在透析过程中在线监测BV变化曲线并结合患者临床表现调整干体重,帮助确定合适的超滤量,能有效防治透析中低血压及高血压的发生.Objective To investigate the role of measurement of blood volume（BV） on-line during hemodialysis as useful tool to modulate dry weight（DW） and prevent from intradialysis hypotension and hypertension. Method 49 end-stage renal disease patients on chronic hemodialysis were randomly selected, were investigated in this study. Accoding to their dialysis manifestations and signs, two groups were divided, group A（n =31） with hypotension, and group B（n = 18） with drug-resistant hypertension. Blood pressure, weight, BV, ultrafiltration volume and clinical manifestations were monitored during hemodialysis sessions for all of patients. Result DW was raised 1.0 - 1.5kg for group A according to the BV curve and patients＇ manifestations. △BV was found to be significantly higher than that before DW was modulated （16.06% ＋2.03% vs.21.03% ± 1.99%,p 〈0.05 = . The patients in group A had had not appeared hypotension again. DW was reduced by 0.5kg for group B. △was found to be significantly lower than that before（11.5 ±0.61% vs.4.36%±0.37%,p〈0.05） . Conclusion Measurement of BV on-line combined with manifestations may be useful to modulate DW and determine appropriate ultrafiltration volume, to prevent from hypotension episodes and drug - resistant hypertension for patients.

关 键 词：血容量 血液透析 干体重 

分 类 号：R459.5[医药卫生—治疗学]