低温可调钠联合线性超滤模式对血液透析中低血压的影响  

Effect of hypothermia variable sodium dialysis combined with ultrafiltration profiling on hypotension in hemodialysis

作　　者：蒙兰芬[1] 张大成[1] 罗学文[1] 徐宏[1] 黄荣贵[1] 关建国[1] 吕静[1] 

机构地区：[1]广西柳州市中医院(广西中医学院第三附属医院)肾内科,广西柳州545001

出　　处：《中国现代医学杂志》2012年第32期72-76,共5页China Journal of Modern Medicine

基　　金：广西区柳州市应用技术研究与开发计划课题基金(No:2009021517);广西区卫生厅自筹经费科研课题(No:Z2008421)

摘　　要：目的探讨不同血液透析(血透)模式对血液透析中低血压的影响。方法选取在血透中容易发生低血压的20例患者,采用4种透析模式(标准常温常规组、低温可调钠组、可调钠+超滤模式组和低温可调钠+超滤模式组)治疗,观察4组不同透析模式中低血压发生率、心率、平均动脉压、超滤量、电解质、毒素等的改变,进行比较分析。结果与标准常温常规组比较,低温可调钠组、可调钠+超滤模式组、低温可调钠+超滤模式组可不同程度地降低血透中低血压发生率,稳定动脉压,并且透析前后毒素均可得到有效清除,低温可调钠+超滤模式组尤其可显著降低血透中低血压发生率,与其他3组比较差异有统计学意义。结论低温可调钠+超滤模式组能显著提高患者的心血管稳定性,有效降低透析中低血压的发生率,值得临床推荐。【Objective】 To explore the effect on hypotension in hemodialysis treated with different modes of dialysis.【Methods】 Twenty patients receiving regular hemodialysis were selected and divided into four groups randomly： conventional group;hypothermia variable sodium dialysis group;variable sodium dialysis combined with ultrafiltration profiling group;hypothermia variable sodium dialysis combined with ultrafiltration profiling group.Their incidence of hypotension,heart rate,mean arterial pressure,ultrafiltration volume,electrolyte and acid-base toxin were monitored and analyzed.【Results】 Compared with conventional group,three other groups can decrease the incidence of hypotension in hemodialysis and stable arterial pressure in different dimensions,can also remove acid-base toxin effectively,especially the hypothermia variable sodium dialysis combined with ultrafiltration profiling group,the difference is significant,（P 0.01）.【Conclusion】 Hypothermia variable sodium dialysis combined with ultrafiltration profiling mode can significantly enhance the cardiovascular stability in dialysis patients,and lower the incidence of hypotension during hemodialysis,it is worthy of recommendation.

关 键 词：低温 可调钠 线性超滤 血液透析 低血压 

分 类 号：R459.5[医药卫生—治疗学]