糖尿病与非糖尿病血液透析患者血压变化的探讨  

Study on the changes of blood pressure in diabetic and non-diabetic patients with hemodialysis

作　　者：任崇[1] 黄碧红[1] 杨晓莉[1] 卢文文[2] 曹艳佩[1] 

机构地区：[1]复旦大学附属华山医院,上海200040 [2]复旦大学护理学院,上海200032

出　　处：《护士进修杂志》2017年第1期16-18,共3页Journal of Nurses Training

基　　金：上海市卫生和计划生育委员会科研课题基金项目(编号:201540085)

摘　　要：目的观察糖尿病维持性血液透析患者透析过程中血压变化特点。方法选取我院血液净化中心80例情况稳定的维持性血液透析患者,分为糖尿病组(Diabetic mellitus group,DM组)及非糖尿病组(non-diabetic mellitus group,NDM组),分析两组患者透析过程中血压的差异。结果透析中糖尿病组的最高收缩压(SBP)、SBP最大差值及最大脉压差显著高于非糖尿病组,最低舒张压(DBP)显著低于非糖尿病组,差异有统计学意义(P<0.05);而透析中两组最低SBP、最高DBP、DBP最大差值差异无统计学意义(P>0.05)。结论糖尿病较非糖尿病血液透析患者透析过程中血压变化更大、更难控制,脉压差更大、血压波动更大(尤其是收缩压)。护理工作人员可以通过准确评估干体质量、设置合适超滤量、调节钠浓度、调节透析液温度、指导进食、做好心理护理等措施来减少血液透析中血压的波动。Objective To investigate the characteristic of blood pressure variability during hemodialysis in hemodialysis patients with diabetic mellitus.Methods 80 stable maintenance hemodialysis patients in the blood purification center was divided into two groups（ diabetic mellitus group and non-diabetic mellitus group）.The difference of blood pressure during hemodialysis between the two groups was analyzed.Results There were significant difference in the highest systolic blood pressure（ SBP）,the maximum difference of SBP,the highest pulse pressure,the lowest diastolic blood pressure（ DBP） during hemodialysis between the two groups（ P0.05）.And there were no significant difference in the lowest SBP,the highest DBP,the maximum difference of DBP during hemodialysis between the two groups（ P 0.05）. Conclusion Blood pressure control was relatively difficult in hemodialysis patients with diabetic mellitus; Pulse pressure and blood pressure fluctuation（ especially SBP） were higher during hemodialysis.The nursing staff can reduce the blood pressure fluctuation by assessing accurate dry weight,setting appropriate ultrafiltration volume,concentration of sodium,dialysis temperature,guiding diet,completing psychological nursing.

关 键 词：糖尿病 血液透析 血压变化 护理 

分 类 号：R473.58[医药卫生—护理学]