缓慢低效透析滤过对维持性血液透析患者低血压状态的影响  

Clinical effect of sustained low-efficiency daily diafiltration in the treatment of maintenance hemodialysis with patients hypotensive status

作　　者：韩志武[1] 闫利忠[1] 朱秀丽[1] 李靖[1] 肖琼[1] 汪婧[1] 徐友平[1] 沈俊[1] 姚国乾[1] 

机构地区：[1]解放军161医院全军血液净化中心,武汉430010

出　　处：《临床肾脏病杂志》2010年第11期497-499,共3页Journal Of Clinical Nephrology

摘　　要：目的探讨应用持续缓慢低效每日透析滤过（SLEDI）-f）对于维持性血液透析（MHD）患者合并低血压状态的临床治疗效果。方法选择我院血液净化中心合并低血压状态的MHD患者36例，应用SLEDI）-f治疗，观察每次治疗过程中患者生命体征指标（血压、脉搏、心率、体温）、血氧饱和度，记录总超滤量、尿素氮和血肌酐变化并计算尿素清除指数（Kt／V）；整个疗程治疗前、后行彩色多普勒超声检测心功能指标，同时监测C反应蛋白（CRP）。结果治疗过程中，患者生命体征稳定，并发症少，透析充分性好。治疗后，患者左心室舒张末期内径（LVDd）较治疗前降低（P〈0．05），心脏指数（CI）及左心室射血分数（LVEF）较治疗前升高（P〈0．05），CRP较治疗前降低（P〈0．01）。结论采用SLEDI）-f治疗可提高MHD合并低血压状态患者对治疗的适应性，显著改善心功能指标，有助于提高患者治疗效果。Objective To evaluate the clinical effect of sustained low-efficiency daily diafiltration （SLEDD-f） in the maintenance hemodialysis （MHD） patients with hypotensive status. Methods 36 MHD patients with hypotensive status were selected, all patients were applicated with SLEDD-f treat- ment. Vital signs during the treatment （blood pressure, pulse, heart rate, body temperature） and oxy- gen saturation were observed, record the total superfilter volume, changes in blood urea nitrogen and serum creatinine, calculated urea clearance index （Kt/V）. Cardiac function were detected by color Doppler ultrasound, while monitoring C-reactive protein （CRP）. Results In stage of treatment, vital signs were stable, complications were infrequent and dialysis adequacy were better. After treatment, left ventricular end diastolic internal dimension （LVDd） was lower than before treatment（P^0. 05）, cardiac index （CI） and left ventricular ejection fraction （LVEF） were higher than before treatment （P d0. 05）,CRP was lower than before treatment （P^0. 01 ）. Conclusion SLEDD-f treatment can im- prove the hypotension status of MHD patients, and improve patient outcomes.

关 键 词：肾透析 低血压 SLEDD-f 

分 类 号：R459.5[医药卫生—治疗学]