肾性贫血患者血液透析中不同静脉补铁方法效果比较  

Effects of Different Methods for Intravenous Iron in Renal Anemia Patients Undergoing Hemodialysis

作　　者：刘绮文[1] 叶燕[1] 黄敬心[1] 

机构地区：[1]佛山市第一人民医院血液净化中心,广东佛山528000

出　　处：《护理学报》2010年第5期41-43,共3页Journal of Nursing（China）

摘　　要：目的观察慢性肾功能衰竭并发肾性贫血患者在血液透析中2种静脉给予蔗糖铁方法的临床效果,探讨静脉补铁的最佳方式。方法将70例慢性肾功能衰竭维持性血液透析并发肾性贫血的患者随机分为两组各35例,在血液透析过程中分别进行动脉端泵前静脉滴注蔗糖铁和静脉端微量泵静脉注射蔗糖铁,均为2次/周,100 mg/次,总剂量1 000 mg。两组患者均常规使用基因重组红细胞生成素治疗,每周剂量为120～200 U/kg,在整个试验过程中保持剂量不变。治疗前、治疗结束后2周检查两组患者血清铁蛋白、血红蛋白、红细胞压积,并进行比较。结果两组患者静脉补铁总剂量1 000 mg治疗结束后2周,血清铁蛋白、血红蛋白、红细胞压积都较治疗前有明显升高,差异有统计学意义(P<0.001);两组患者各指标升高的幅度差异无统计学意义(P>0.05)。结论动脉端泵前静脉滴注、静脉端微泵静脉注射蔗糖铁都可应用于血液透析中静脉补铁,效果相当,但动脉端泵前静脉滴注方法只需使用静脉输液器,与使用微量泵比较,更适合血液透析过程中多例患者同时静脉补铁的应用,更能节省护理人力。Objective To observe the effects of two methods for intravenous iron in renal anemia patients undergoing hemodialysis so as to explore the better method for intravenous iron. Methods 70 patients with chronic renal failure complicated with renal anemia during hemodialysis were evenly randomized into two groups： intravenous drip of iron sucrose through arterial side and micro pump infusion of iron sucrose through venous side, twice every week, 100 mg each time and with a total volume of 1 000 mg. All the patients were treated by r-HuEpo at a total dosage of 120-200 U/kg all through the course. The serum ferritin, hemoglobin and HCT were tested in the two groups before and two weeks after treatment, and then compared between the groups. Results Compared to pre-treatment, the serum ferritin, hemoglobin and HCT increased significantly two weeks after that （P〈0.001）, but the increases in the indexes within each group were no significant （P〉0.05）. Conclusion intravenous drip of iron sucrose through arterial side and micro pump infusion of iron sucrose through venous side are suitable for effective intravenous iron during hemodialysis, but the former is more suitable for simultaneous reinforcements for more patients, which can save more nursing manpower.

关 键 词：慢性肾功能衰竭 血液透析 肾性贫血 静脉补铁 血清铁蛋白 

分 类 号：R459.5[医药卫生—治疗学]