肾衰竭患者初次血液透析急性并发症临床观察  

Acute complications in patients with renal failure undergoing initial hemodialysis

作　　者：孙兆峰[1] 刘岩[1] 张霞 

机构地区：[1]泰安市中心医院,山东271000 [2]泰安市泰山区省庄卫生院

出　　处：《社区医学杂志》2012年第10期19-21,共3页Journal Of Community Medicine

摘　　要：目的分析初次血液透析急性并发症的发生原因及机制,以求采取干预措施降低发生率。方法回顾性分析206例肾衰竭患者初次血液透析临床资料,统计各种急性并发症的发生率,透析过程中每半小时监测一次心率、呼吸次数、血压,并于透析前后抽血检测钾、钠、氯、血糖、尿素氮和血肌酐,进行比较。结果 206例患者共发生低血压25例(12.1%),失衡综合征20例(9.7%),低血糖症4例(1.9%),低氧血症2例(0.9%),颅内出血1例(0.5%);与透析前相比较,随着透析时间的增加,心率、呼吸次数和血压渐进性下降,差异有统计学意义(P<0.05)。206例患者透析后血钾、血糖、尿素氮和血肌酐明显下降,差异有统计学意义(P<0.05)。结论血液透析可快速缓解尿毒症患者症状,医护人员掌握透析急性并发症的发生原因和机制,积极采取预防措施,可有效降低急性并发症的发生率,使患者平稳、安全度过透析诱导期。Objective To analyze the causes and mechanisms of acute complications in patients with renal failure undergoing initial hemodialysis,in order to reduce the incidence of complications.Methods In a retrospective study,clinical data of 206 cases with renal failure who had received initial hemodialysis were analyzed for the incidence rate of all acute complications.Respiration,heart rate and blood pressure were monitored every 30 min during the process of hemodialysis.Blood potassium,sodium,chloride,glucose,urea nitrogen and serum creatinine were determined before and after hemodialysis for comparison.Results Of 206 cases,25 developed low blood pressure（12.1%）,20 imbalance syndrome（9.7%）,4 hypoglycemia（1.9%）,2 hypoxia（0.9%）,and 1 intracranial bleeding（0.5%）;respiration,heart rate and blood pressure declined progressively as the duration of dialysis increased,significant difference was found between them（P〈0.05）.Blood potassium,glucose,urea nitrogen and serum creatinine in all 206 patients declined obviously after dialysis and there was significant difference（P〈0.05）.Conclusions Hemodialysis can quickly relieve the symptoms of uremia.Medical staffs should grasp the causes and mechanisms of acute complications in hemodialysis and take preventive measures so as to lower the incidence of acute complications effectively and to help patients through induction period of dialysis smoothly.

关 键 词：肾衰竭 血液透析 急性并发症 失衡综合征 透析诱导期 

分 类 号：R459.5[医药卫生—治疗学]