低温透析对血透中血压及透析质量的影响  

Effects of Cool Temperature Dialysate on the Quality and Patients' Perception of Hemodialysis

作　　者：叶建明[1] 郁丽霞[1] 陈洪磊[1] 缪静龙[1] 郁卫华[1] 

机构地区：[1]昆山市第一人民医院肾内科,江苏昆山215300

出　　处：《苏州大学学报（医学版）》2006年第5期812-814,817,共4页Suzhou University Journal of Medical Science

摘　　要：目的探讨低温透析对透析过程中低血压的发生、尿素氮的清除、超滤量以及患者血透感觉的影响。方法选取在血透时易发生低血压的20名患者为一组,在透析期间及透后均保持稳定血压的20名患者为另一组,分别进行自身对照研究。每位患者分别进行8次低温(35.5℃)透析,8次常温(37℃)透析。观察尿素消除指数(Kt/V)、尿素下降率(URR)、透析超滤体积(UF)、血压、脉搏、体温和低血压发生情况及患者自我感觉的表述。结果在低血压组用低温透析能提高超滤量和透析期间及透后的平均动脉压,降低低血压的发生率,而对稳定组则无影响。透析期间两组的脉率、尿素氮的清除、Kt/V相似。而两组中75%的患者感觉低温透析后精力更充沛。结论低温透析能减少低血压的发生,提高超滤,透析充分,且患者对低温透析感觉良好,是一种简单、有用、经济的透析方法,透析室环境温度适宜的情况下可适当降低透析液温度,既不影响透析质量,又可节约电能。Objective To evaluate the effects of cool temperature dialysate on the quality and patients＇ perception of haemodialysis, and to provide scientific basis for individualized temperature dialysate formula. Methods The first group of ten patients were known to have hypotension episodes during dialysis, and the second group of ten patients were documented as having stable blood pressure during and after dialysis. Each patient was dialysed for eight sessions using cool dilaysate（35.5℃ ）fol- lowed by another eight sessions using a standard dialysate temperature（37℃）. Kt/V, URR, UF, BP, pulse, temperature and the number of hypotension episodes were assessed with different temperature diaysate. Result The ultrafiltration and the mean arterial pressure post-and intra-dialysis were higher in dialysis with cool dialyate in the low BP group. But in the stable BP group they remained unchanged when cool dialysate was used. There were no significantly differences in the pulse, URR and Kt/V between cool dialysate and standard dialysate in both groups. 75 % of patients felt more energetic after dialysis. Conculsions Cool dialysate diminishes the number of hypotension episodes and helps increase ultrafiltration. Patients＇ perceptions were positive. The use of cool dialysate is a simple, useful and economical procedure.

关 键 词：血液透析 低温透析 常温透析 低血压 超滤 自我感觉 

分 类 号：R459.5[医药卫生—治疗学]