营养不良患者透析低血压的预防  

The prevention of hypotention occurring during hemodialysis in subnutrition patients

作　　者：刘艳红[1] 段晓霞[1] 张彩霞[1] 

机构地区：[1]河南省漯河市中心医院肾内科,漯河462000

出　　处：《中原医刊》2006年第7期19-20,共2页Central Plains Medical Journal

摘　　要：目的探讨降低慢性肾功能衰竭(肾衰)营养不良患者透析低血压发生率的方法。方法选择8例尿毒症营养不良患者的93次透析作回顾性分析,随机分为5组,以常规方式作对照组,比较5种治疗方式下低血压的发生率和实际完成超滤量。结果透析低血压发生率从低到高的顺序依次为:A组:输血或白蛋白(0),B组:诱导+多巴胺(0),C组:诱导方式(12.50%),D组:不超滤或超滤量<2kg(13.33%),E组:常规组(38.46%)。透析低血压发生率经统计学处理,与常规对照组比较:A、B组差异均有统计学意义(P<0.05);C、D组差异均无统计学意义(P>0.05)。C组和D组比较,差异无统计学意义(P>0.05)。超滤量经统计学处理,A、B、C组与常规对照组比较,差异均有统计学意义(P<0.01),C组和D组比较,差异有统计学意义(P<0.05)。结论营养不良患者透析中应用血制品仍是预防低血压的最佳选择,常规方式易发生心脑血管并发症,诱导方式和加用多巴胺亦有预防作用,单纯诱导透析超滤量少,加用多巴胺可有效地提高超滤量。Objective To explore the way of reducing the percentage of hypotention during hemodialysis in subnutrition patients with chronic kidney dysfunction. Methods Ninty - three times hemodialysis of 8 cases of subnutrition patients with chronic kidney dysfunction were analyzed retrospectively. It was divided into 5 groups randomly, routine way as control group. Compare the percentage of hypotention occurring and actural volume of ultration in 5 groups. Results From low to high,the percentage of hypotention occur were： A group, blood transfusion or ablution（0） ;B group,leading way ＋Dopa（0） ;C group,simply leading way （25%） ;D group,without ultration or volume of uhration below 2kg（ 13% ） ;E group,routine way （38%）. With statistic analysis,the percentage of hypotention occurring of A,B group were significantly lower than that of E group respectively. There was no difference between C or D group and E group. And there was also no difference between C and D group. The volume of uhration A, B group were significantly higher than that of E group respectively. And there was no difference between C and D group. Conclusion Blood transfusion is still the best selection way of preventing hypotention during hemodialysis in subnutrition patients with chronic kidney dysfunction. Cardio - vascular events occurs easily in the routine way,leading way and giving Dopa are efficient partly,in simply leading hemodialysis the volume of ultration is low, giving Dopa in hemodialysis maybe enhigh the volume of uhration.

关 键 词：营养不良 低血压 透析 预防 

分 类 号：R692.5[医药卫生—泌尿科学] R591[医药卫生—外科学]