进食时间对血液透析患者透析相关低血压的影响  

Effect of food intake at different time on intradialytic hypotension of patients

作　　者：鄢建军[1] 夏丹[1] 童辉[1] 刘慎微[1] 吕永曼[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院血液净化中心,湖北武汉430030

出　　处：《护理学杂志》2010年第7期35-37,共3页

摘　　要：目的探讨进食时间对血液透析患者血压的影响。方法对经常发生透析相关性低血压的维持性血液透析患者39例(289例次)按不同进食时间分为禁食组(109例次)、透析2h内进食组(88例次)及透析3h后进食组(92例次)。禁食组治疗前常规进食,治疗开始后全程禁食禁饮,透析结束后再进食;2h内进食组透析开始1.5～2.0h进食,总量不超过500g;3h后进食组透析开始3.5h左右进食,总量不超过500g。结果三组进食前后平均动脉压(MAP)差、相对血容量、超滤量以及最低MAP,以及三组低血压、症状性低血压发生率及护理干预率比较,差异有统计学意义(均P<0.01);3h后进食组各指标与其余两组比较,差异有统计学意义(均P<0.0125);三组发生透析相关低血压者提前终止透析的比例比较,差异无统计学意义(P>0.05)。结论有低血压倾向的透析患者应选择在透析1.5～2.0h进食,有助于预防血液透析中低血压的发生。Objective To explore the effect of food intake at different time on blood pressure in the process of hemodialysis. Methods Totally, 289 hemodialysis sessions were collected from 39 maintenance hemodialysis patients who had hypotension frequently during hemodialysis. These hemodialysis sessions were divided into three groups： group I included 109 sessions, and the food intake were prohibited in the process of hemodialysis; group Ⅱ had 88 sessions, in which patients took food at 1.5 2.0 hours of hemo dialysis. The remaining 92 sessions were collected in group Ⅲ , and these patients took food at 3.5 hours of hemodialysis. The food taken weighted no more than 500 g. Results The difference of mean arterial pressure（MAP） before and after food intake, the changes of relative blood volume （ARBV）,and total volume of ultrafiltration （UF）, the minimal MAP, rates of hypotension and symptomatic hypotension had significant differences among the 3 groups （P〈0.01 for all）. Compared with the other two groups, the differences in the above mention parameters in group Ⅲ were most significant（ P〈0. 0125）. The proportion of unexpected termination of dialysis among the 3 groups had no significant differences（P〉0.05）. Conclusion For hypotension-prone patients, food intake at 1.5-2.0 h of hemodialysis can be helpful to avoid hypotension.

关 键 词：血液透析 进食 低血压 护理 

分 类 号：R473.5[医药卫生—护理学]