控温、钠曲线、阶梯超滤模式个体化联合对透析中低血压的疗效评价  

Curative Effect Evaluation of Individual Combination of Temperature Control,Sodium Curve and Step Ultrafiltration Mode on Intradialytic Hypotension

作　　者：李文宏[1] 陈浩[1] 殷玉敏[1] 乔丽[1] 时薇[1] 叶吉云[2] 

机构地区：[1]昆明医科大学附属延安医院,云南昆明650051 [2]昆明医科大学,云南昆明650500

出　　处：《昆明医科大学学报》2015年第1期73-76,共4页Journal of Kunming Medical University

基　　金：云南省应用基础研究基金资助项目(2011FB150)

摘　　要：目的研究控温、钠曲线、阶梯超滤模式个体化联合应用对透析中低血压(intradialytie hypotension,IDH)的疗效,探讨IDH的合理处理方案.方法选取维持血透(maintence hemodialysis,MHD)中常发生低血压患者60例,随机分成2组(实验组和对照组),每组各30人,对照组采用常温标准透析模式,实验组根据IDH发生的规律,个体化的设定透析机内部温度、钠曲线、阶梯超滤模式联合应用进行透析,比较2组透析中低血压发生频率、症状评分、干体重达标率、透析中、透析结束后的血压变化及透析后电解质(钠、钾、氯)的变化情况.结果实验组低血压总发生率、干体重达标率、透析中、透析结束后的血压质量均优于对照组(P<0.05);实验组症状评分(头晕评分、胸闷评分、出汗评分、肌肉痉挛评分、胃肠道症状评分、短暂神智改变评分)均比对照组低(P<0.05);2组透析后血清钠、钾、氯浓度无统计学差异(P>0.05).结论控温、钠曲线、阶梯超滤模式个体化联合应用对预防及控制IDH的发生、改善症状、提高干体重达标率安全有效.Objective To research the curative effect of individual combination of temperature control, sodium curve and step ultratqhration mode on intradialytic hypotension （IDH） , and to investigate the reasonable treatment scheme of IDH. Methods 60 patients with a high incidence of hypotension of maintenance hemodialysis （MHD） , randomly divided into two groups （experimental group and control group） , with 30 patients in each group, and normal standard dialysis mode was used in control group. According to the occurrence regularity of IDH, the internal temperature, sodium dialysis machine, curve, stepuhrafiltration mode combined with hemodialysis were set individual. The frequency of occurrence of IDH, symptom scores, dry body weight, blood pressure change during and after dialysis, and electrolyte （sodium, potassium, chlorine） after dialysis were compared between the two groups. Results The total incidence of hypotension, dry body weight, blood pressure during and after dialysis in experimental group were better than those of control group （P 〈 0.05） . The symptom scores （dizziness, chest tightness, sweating score, muscle spasm, gastrointestinal symptoms score, short mental change score） were lower than those of control group （P 〈 0.05） . But there were no significant differences in serum sodium, potassium and chlorine concentrations between the two groups after dialysis （P 〈 0.05） Conclusion The individual combination of temperature control, sodium curve and step uhrafiltration mode is safe and effective,which can prevent and control the occurrence of IDH, improve symptoms and increase dry weight success rate.

关 键 词：透析低血压 温度模式 钠模式 阶梯超滤 个体化治疗 联合治疗 

分 类 号：R617[医药卫生—外科学]