透析液温度不同调整方法对老年患者低温透析耐受性的影响  

Effects of different methods of dialysate temperature adjustment on the tolerance of low temperature dialysis in elderly patients

作　　者：唐红艳 袁海川 王蕾 朱思珠 周兰 谷娟 TANG Hongyan;YUAN Haichuan;WANG Lei;ZHU Sizhu;ZHOU LAN;GU Juan(Department of Geriatrics,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院老年肾科血透室,南京210029

出　　处：《重庆医学》2020年第S01期69-72,共4页Chongqing medicine

基　　金：透析液温度不同调整方法对老年患者低温透析耐受性的影响(YHK201747)。

摘　　要：目的探讨透析液温度不同调整方法对老年患者低温透析耐受性的影响。方法选取2018年7月至2019年12月该院收治的终末期肾脏病血液透析治疗的28例患者,采取抽签随机分组法分为阶梯式降温组和渐进式降温组,各14例,比较两组患者不适反应、舒适度评分及动脉压、心率变化。结果渐进式降温组不适症状总发生率为21.43%,低于阶梯式降温组(42.86%),但两组比较差异无统计学意义(P>0.05);阶梯式降温组从第6次透析开始舒适度得到显著改善(P<0.05);组间比较显示,第1、3次两组间舒适度评分比较差异无统计学意义(P>0.05),第6、12次透析时阶梯式降温组舒适度评分均明显低于渐进式降温组(P<0.05);两组患者末次透析前后时心率、动脉压均未出现明显变化(P>0.05),且两组患者组间比较差异均无统计学意义(P>0.05)。结论阶梯式降温与渐进式降温均能有效改善老年透析患者耐受性,而二者有各自的优势,实际调温方式选择有待结合患者个体差异予以个体化调节。Objective To explore the effect of different methods of adjusting dialysate temperature on the tolerance of low temperature dialysis in elderly patients.Methods 28 patients with end-stage renal disease hemodialysis treated in our hospital from July 2018 to December 2019 were selected The patients were randomly divided into a step cooling group and a progressive cooling group by drawing lots,14 cases each,comparing the discomfort response,comfort score,arterial pressure and heart rate changes of the two groups of patients.Results The total discomfort symptoms of the progressive cooling group The incidence rate was 21.43%,lower than the step cooling group(42.86%),but the difference between the two groups was not statistically significant(P>0.05);the step cooling group had a significant improvement in comfort from the 6th dialysis(P<0.05);Comparison between the groups showed that there was no significant difference in the comfort scores between the first and third times(P>0.05).The comfort scores of the step cooling group on the 6th and 12th dialysis were significantly lower than the progressive cooling Group(P<0.05);There was no significant change in heart rate and arterial pressure between the two groups of patients before and after the last dialysis(P>0.05),and the difference between the two groups was not statistically significant(P>0.05).Conclusion Both stepped cooling and gradual cooling can effectively improve the tolerance of elderly dialysis patients,and both have their own advantages.The actual temperature adjustment method needs to be adjusted individually according to the individual differences of patients.

关 键 词：血液透析 低温透析 老年 耐受性 舒适度 

分 类 号：R47[医药卫生—护理学]