尿毒症治疗中血压改变对血液透析患者生存状况的影响研究  

Study on the effect of blood pressure changes on survival of hemodialysis patients during uremia treatment

作　　者：石海燕 SHI Hai-yan(Department of Nephrology,the First People′s Hospital of Fuzhou,Jiangxi Province,Fuzhou 344000,China)

机构地区：[1]江西省抚州市第一人民医院肾内科,江西抚州344000

出　　处：《中国当代医药》2019年第11期51-53,共3页China Modern Medicine

基　　金：江西省抚州市社会发展指导性科技计划项目(抚科计字[2018]5号序列号12)

摘　　要：目的分析尿毒症治疗中血压改变对血液透析患者生存状况的影响。方法选取2016年12月～2018年12月我院收治的90例尿毒症患者作为研究对象,根据血压的不同将其分为正常血压组与高血压组,每组各45例。比较两组患者的血清钙、血清磷、甲状旁腺激素、胆固醇、血清清蛋白、血红蛋白水平、尿素清除指数、血透期体重增长情况、透析前后的收缩压、舒张压、平均动脉压,并比较两组患者的死亡率。结果两组患者的血清钙、胆固醇水平及尿素清除指数比较,差异无统计学意义(P>0.05);高血压组患者的血清磷、甲状旁腺激素水平及血透期体重增长量均高于正常血压组,血清清蛋白、血红蛋白水平均低于正常血压组,差异有统计学意义(P<0.05)。高血压组患者透析前、透析后的收缩压、舒张压及均平均动脉压均高于正常血压组,差异有统计学意义(P<0.05)。高血压组患者的死亡率为20.00%(9/45),高于正常血压组的4.44%(2/45),差异有统计学意义(P<0.05)。结论在进行血液透析时要注意控制患者体重,同时避免患者透析后血压过度降低。只有控制患者血压过度升高和降低方可降低患者的死亡率,延长生存时间。Objective To analyze the effect of blood pressure changes on the survival of hemodialysis patients during uremia treatment.Methods Ninety patients with uremia admitted to our hospital from December 2016 to December 2018 were selected as subjects.According to the blood pressure,they were divided into normal blood pressure group and hypertension group,with 45 cases in each group.The levels of serum calcium,serum phosphorus,parathyroid hormone,cholesterol,serum albumin and hemoglobin,urea clearance index,hemodialysis weight gain,systolic blood pressure,diastolic blood pressure,mean arterial pressure before and after dialysis were compared between the two groups.The mortality between the two groups was also compared.Results There were no significant differences in serum calcium,cholesterol levels and urea clearance index between the two groups(P>0.05).The levels of serum phosphorus,parathyroid hormone and weight gain during hemodialysis period in the hypertensive group were higher than those in the normal blood pressure group,serum albumin,and hemoglobin levels were lower than those in the normal blood pressure group,and the differences were statistically significant(P<0.05).The systolic blood pressure,diastolic blood pressure and mean arterial pressure of the patients in the hypertension group were higher than those in the normal blood pressure group before and after dialysis,and the differences were statistically significant(P<0.05).The mortality of the hypertension group was 20.00%(9/45),which was higher than that of the normal blood pressure group accounting for 4.44%(2/45),and the difference was statistically significant(P<0.05).Conclusion Care should be taken to control the patients′ weight during hemodialysis,while avoiding excessive blood pressure reduction after dialysis.Only by controlling the patients′ excessive rise and decrease of blood pressure can their mortality be reduced and the survival time extended.

关 键 词：尿毒症 血压 血液透析 生存状况 

分 类 号：R692.5[医药卫生—泌尿科学]