维持性血液透析中低血压的防治  

Prevention and Treatment for Hypotension in Patients undergoing Maintaining Hemodialysis

作　　者：刘蠡 王伟鸿[2] 林光 苏文标[2] 陈桂林 黄国安 林瑞川 

机构地区：[1]广东省汕头市澄海人民医院,广东澄海515800 [2]汕头大学医学院第一附属医院,广东汕头515000

出　　处：《河北医学》2007年第1期9-11,共3页Hebei Medicine

摘　　要：目的:探讨维持性血液透析中低血压的防治方法。方法:回顾性分析149例维持性血液透析病人进行14682例次血液透析,透析过程中发生低血压2853例次的临床过程。结果:本组病例于血液透析中出现低血压的发生率19.4%,抢救成功率99.1%。结论:低血压是维持性血液透析中的常见急性并发症,应进行紧急处理:降低体外循环血流量,停止超滤,使病人头低臀高位、吸氧、快速泵前输入高渗液体,大部分病人血压能回升并完成透析治疗。结合具体病人个体差异,调整超滤率和循环血量;修正干体重;使用单纯超滤和序贯透析,保证透析充分性;合理使用降血压药物;积极治疗肾性贫血和营养不良等,能减少透析中低血压的发生。Objective： To discuss the preventing and controlling of hypotension during maintenance hemodialysis. Method：Analysing the clinical process of hypotension about 149 cases patients carried on 14, 682 examples maintenance hemodialysis. Result：The occurrence rate of hypotension is 19.4%, and the rescue succes rate of hypotension is 99.1% in patients of hemodialysis. Conclusion： The hypotension is main acute complication during the maintenance hemodialysis, and should be carried on urgent process： such as reducing the external circulation blood current, stopping ultra filtering, causing patients to the top buttock and low head, give the oxygen, lastly pump into high infiltrates liquids. After the treatment, blood pressure rise again for majority patients and hemodialysis can be completed. According to individual difference of patients, adjusting ultra filtering rate and circulation blood current; revising the body weight; using purely ultra filtering and foreword process hemodialysis to insure hemodialysis sufficiency; reasonably using reduction blood pressure medicine ; positive treating the kidney anemia and the malnutrition all can reduce the hypotension occurrences during the maintenance hemodialysis.

关 键 词：维持性血液透析 低血压 防治 

分 类 号：R459.5[医药卫生—治疗学]