不同透析模式联合低分子肝素对终末期肾病患者血流动力学及脑出血发生的影响  

Effects of Different Dialysis Modes Combined with Low Molecular Weight Heparin on Hemodynamics and Cerebral Hemorrhage in Patients with End Stage Renal Disease

作　　者：吴声恺 曾斌[1] WU Sheng-kai;ZENG Bin(The Second Peoples Hospital of Shantou,Shantou,Guanong province,515000)

机构地区：[1]广东汕头市第二人民医院,广东汕头515000

出　　处：《医学临床研究》2019年第2期271-273,共3页Journal of Clinical Research

摘　　要：【目的】探讨不同透析模式联合低分子肝素对终末期肾病(ESRD)患者血流动力学及脑出血发生的影响。【方法】根据采用透析模式的不同,将96例ESRD患者分为间歇性透析组(A组)和连续性透析组(B组),每组48例。比较两组的心脏功能、血流动力学指标及相关因子变化和治疗期间的不良事件发生情况。【结果】治疗3个月后两组患者的平均血压、心输出量、心脏指数、每搏量、每搏指数和平均颅内压与治疗前比较差异均无显著性(P>0.05);A组每搏量变异显著高于B组,且差异有显著性(P<0.05)。透析后B组的内皮素-1(ET-1)显著升高,且高于A组(P<0.05),两组的白细胞介素-6(IL-6)、硫代巴比妥酸反应物(TBARS)和E型利钠肽(BNP)治疗前后相比差异均无显著性(P>0.05)。两组的脑出血、脑梗死和严重感染发生率相比差异均无显著性(P>0.05)。【结论】间歇性及连续性血液透析两种模式分别联合低分子肝素对ESRD患者的血流动力学和脑出血发生的影响无明显差异,临床上可视具体情况灵活选择。【Objective】explore the effects of different dialysis modes combined with low molecular weight heparin on hemody namics and cerebral hemorrhage in patients with end-stage renal disease(ESRD).【Methods】According to the different dialysis modes,a total of 96 patients with ESRD were divided into the in termittent dialysis group(group A,n=48)and the continuous dialysis group(group B,n=48).The changes of cardiac function hemodynamic parameters and related factors,and the occurrence of adverse events during treatment were compared between the two groups.【Results】There were no significant differences in mean blood pressure,cardiac output,cardiac index,stroke volume,stroke index and intracranial pressure between the two groups before treatment(P>0.05).Compared to before treatment,the variation of stroke volume in group A was higher than that in group B(P<0.05).After dialysis the level of endothelin-1(ET-1)in group B was significantly higher than that in group A(P<0.05).There were no significant differences in interleukin-6(IL-6),thiobarbituric acid reactant(TBARS)and B-type natriuretic peptide(BNP)between the two groups(P>0.05).No significant differences were shown in the incidence of cerebral hemorrhage,cerebral infarction and severe infection between the two groups(P>0.05).【Conclusion】In termitte nt and continuous hemodialysis combined with low molecular weight heparin have no significant difference in hemodynamics and cerebral hemorrhage in patients with ESRD,so it can be flexibly selected according to the specific situation in clinic.

关 键 词：血液透析滤过 肾疾病 脑出血 

分 类 号：R692[医药卫生—泌尿科学]