低温人工肾透析过程的低血压现象  

Hypotension during low-temperature artificial kidney dialysis

作　　者：陈万欣[1] 张志民[1] 朱菊平[1] 胡桂才[1] 董巧荣[1] 王景福[1] 

机构地区：[1]承德医学院附属医院肾脏内科,河北省承德市067000

出　　处：《中国组织工程研究与临床康复》2007年第21期4234-4235,共2页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:观察低温对人工肾透析中低血压的预防作用。方法:实验于2006-08/12在承德医学院附属医院血液透析室完成。选择2004-11/2006-12于承德医学院附属医院进行人工肾透析的患者20例,患者均采用两种不同温度的透析液进行透析,即低温透析(35.0℃)与常温透析(37.0℃),透析后达干体质量。透析前患者休息15min后测量血压、心率,透析进行过程中每30min测血压、心率及超滤量。采用自身对照的方法比较透析前及透析过程中的血压、心率及超滤量,并观察患者低血压时有无不适症状。透析剂量3次/周,4h/次。结果:20例患者全部进入结果分析,共行低温透析160次,常温透析160次。①低温透析前后患者的心率无明显改变,常温透析时心率较透析前略升高(86.5±6.9,75.6±8.2)次/min,收缩压、舒张压及平均动脉压均有所降低;与常温透析相比,低温透析时患者的心率明显下降[(78.4±7.1)次/min(P<0.05)],收缩压、舒张压及平均动脉压均明显升高(P<0.05),超滤量明显升高(P<0.05)。②低温透析时低血压相关并发症的发生率显著低于常温透析(10%,91%,P<0.05)。结论:与常温透析相比,低温透析时低血压的发生率明显降低,心血管功能比较稳定。低温是降低人工肾透析中低血压及相关并发症发生率的有效方法。AIM： To observe the prevention of low temperature on hypotension during artificial kidney dialysis. METHODS： The experiment was performed in Hemodialysis Center of Hospital Affiliated to Chengde Medical College from August to December 2006. Totally 20 chronic hemodialysis patients who ware treated in the Hospital Affiliated to Chengde Medical College from November 2004 to December 2006 ware selected into the experiment. The patients ware dialyzed at two different temperature, namely low temperature （35.0 ℃） and normal temperature （37.0 ℃）. All patients got dry body mass after hemodialysis. After resting for 15 minutes blood pressure and heart rate were measured before dialysis. Blood pressure, heart rate and ultrafiltration volume ware measured every 30 minutes in all patients during dialysis, and then the results ware assessed by self-control. Whether the patients had discomfort symptom or not was observed. Dislysis was performed 3 times a week and once 4 hours. RESULTS： A total of 20 patients warP, involved in the result analysis. There ware low temperature dialysis for 160 times and normal temperature dialysis for 160 times. （1）There was no significant change of heart rate before and after low temperature dialysis, and heart rate was increased during normal temperature dialysis （86.5± 6.9,75.6 =8.2） times/min, and levels of systolic blood, diastolic pressure and mean arterial pressure ware decreased. Compared with normal temperature dialysis, heart rate was obviously decreased during low temperature dialysis [（78.4±7.1 ） times/min （P 〈 0.05）], but levels of systolic blood, diastolic pressure and mean arterial pressure were markedly increased （P 〈 0.05）, and ultrafiltration volume was remarkably increased （P 〈 0.05）. Incidence rate of complication due to hypotension during low temperature dialysis Was distinctly lower than that during normal temperature dialysis （ 10%,91%, P 〈 0.05）. CONCLUSION： The incidence rate of hypotension during low temperature di

关 键 词：低温 人工 肾 人工 血液透析 低血压 人工器官 

分 类 号：R969.1[医药卫生—药理学]