持续缓慢低效血液透析对老年维持性血液透析患者血液动力学的影响  

Effects of Sustained Low-efficiency Hemodialysis during Hypotension in Maintenance Elderly Hemodialysis Patients

作　　者：高飞[1] 孟建中[1] 宋平[1] 于颖[1] 王艳玲[1] 

机构地区：[1]济南军区总医院,济南250031

出　　处：《生物医学工程研究》2009年第1期63-66,共4页Journal Of Biomedical Engineering Research

摘　　要：观察持续缓慢低效血液透析（SLED）对老年维持性血液透析患者血液动力学的影响。老年维持性血液透析患者20人，采用自身对照法分为两组。对照组（A组，n=20）行普通血液透析4h；SLED组（B组，n=20）行持续缓慢低效血液透析6h。所有患者分别于血透前（T0）、开始血透后30、60、90、120、180、240、300、360min（T1-T8）使用Bioz．ICG监测仪（CardioDynamics，San Diego，CA）实时监测并记录血液动力学参数。结果表明：两组血液动力学各指标的基础值（T0）之间无显著性差异（P〉0．05）；两组均于开始治疗后（T1），HR明显加快，MAP明显下降，cI降低，SVRI明显下降（P〈0．01）。SLED组于SLED治疗120min后，各时点（T4～T8）MAP、SVRI较对照组和治疗前（T0）均有显著性增高（P〈0．01）；HR于SLED治疗120min后，各时点（T4～T8）较治疗开始后30min（T1）及对照组明显下降（P〈0．05）；两组CI、CO开始透析30min，各时点（T0～T6）均有不同程度下降（P〈0．05或0．01），但SLED治疗结束时（T8）较治疗前（T0）及对照组明显增加（P〈0．05或0．01）。说明持续缓慢低效血液透析治疗有利于纠正老年维持性血液透析患者血透时的低血压状态，提高血透充分性，改善低血压血透患者的血液动力学。To observe the effects of sustained low-efficiency hemodialysis during hypotension in maintenance elderly hemodialysis patients. Twenty maintenance hemodialysis patients with hypotension were randomly divided into two groups. Control group （group A, n=20）, ordinary trip hemodialysis 4 h; sustained low-efficiency hemodialysis group （group B, n=20）, sustained low-efficiency hemodialysis 6 h. The hemodynamic parameters of all the patients with before hemodiaIysis（T0）, after starting hemodialysis 30, 60,90,120,180,240,300,360 min（T1～T8） were monitored and recorded by Bioz. ICG Monitor. Results showed that there was no significant difference between the hemodynamic parameters of two groups （P〉0.05）. FIR accelerated markedly, MAP decreased significantly, cI decreased, SVRI decreased significantly of beth groups aften beginning treatment（T1） （ P〈0.01 ）. The MAP, SVRI at each point（T4 ～T8） of SLED group after 120 min＇s treatment （To） were significantly increased compared with the control group and before treatment （ P〈0.01 ）. In SLED, HR at each time point （T4～T8 ） after 120 min＇s treatment was significantly decreased （P〈0.05） compared with the group treated with 30 min and control group. CI, CO of both groups at each time point（T1～T6 ）decreased in varying level（ P〈0.05 or 0.01 ） after beginning dialysis with 30 min,but they increased significantly（P〈0.05 or 0.01 ）at the end of SLED treatment（T8） compared with before treatment（T0） and control group. It is concluded that SLED can adjust the hypotension state of the patients and improve the hemodialysis fully and the patient＇s hemodynamic.

关 键 词：持续缓慢低效血液透析 老年 血液动力学 低血压 维持性血液透析 

分 类 号：R318[医药卫生—生物医学工程]