血容量监测联合米多君治疗维持性血液透析低血压患者的临床研究  

Clinical Study of Blood Volume Monitoring Combined with Midodrine in Patients with Maintenance Hemodialysis Hypotension

作　　者：彭金 肖三法 袁海花 PENG Jin;XIAO San-fa;YUAN Hai-hua(Department of Nephrology,Yudu County People's Hospital,Yudu 342300,Jiangxi,China)

机构地区：[1]于都县人民医院肾内科,江西于都342300

出　　处：《医学信息》2021年第23期50-53,共4页Journal of Medical Information

基　　金：赣州市指导性科技计划项目(编号:GZ2020ZSF602)。

摘　　要：目的研究血容量监测联合米多君治疗维持性血液透析低血压患者的临床效果。方法选取2020年4月-2021年8月我院收治的60例维持性血液透析低血压患者,随机分为对照组与观察组,各30例。对照组采用米多君治疗,观察组应用血容量监测联合米多君治疗,比较两组临床疗效、平均动脉压、心率、透析过程中血压变化情况、透析中低血压(IDH)发生率及脱水量。结果观察组治疗总有效率高于对照组(96.67%vs 80.00%),差异有统计学意义(P<0.05)。透析2 h后,两组平均动脉压下降,心率升高,但观察组平均动脉压高于对照组,心率低于对照组,差异有统计学意义(P<0.05)。透析过程中,两组收缩压、舒张压水平均有下降,但观察组高于对照组,透析后,两组收缩压、舒张压水平上升,观察组高于对照组,差异有统计学意义(P<0.05)。观察组IDH发生率低于对照组(3.33%vs 23.33%),脱水量高于对照组,差异有统计学意义(P<0.05)。结论血容量监测联合米多君治疗维持性血液透析低血压,临床疗效确切,可维持透析中体征指标的稳定性,减少血压波动,降低透析中低血压的发生风险,保证脱水量。Objective To study the clinical effect of blood volume monitoring combined with midodrine in the treatment of maintenance hemodialysis hypotension.Methods A total of 60 patients with maintenance hemodialysis hypotension admitted to our hospital from April 2020 to August 2021 were randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with midodrine,and the observation group was treated with blood volume monitoring combined with midodrine.The clinical efficacy,mean arterial pressure,heart rate,blood pressure changes during dialysis,incidence of hypotension(IDH)during dialysis and dehydration were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(96.67%vs 80.00%),and the difference was statistically significant(P<0.05).After 2 h of dialysis,the mean arterial pressure of the two groups decreased and the heart rate increased,but the mean arterial pressure of the observation group was higher than that of the control group,and the heart rate was lower than that of the control group,and the difference was statistically significant(P<0.05).During dialysis,the systolic and diastolic blood pressure levels of the two groups decreased,but the observation group was higher than the control group;after dialysis,the systolic and diastolic blood pressure levels of the two groups increased,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).The incidence of IDH in the observation group was lower than that in the control group(3.33%vs 23.33%),and the dehydration rate was higher than that in the control group,the difference was statistically significant(P<0.05).Conclusion Blood volume monitoring combined with midojun in the treatment of maintenance hemodialysis hypotension has definite clinical efficacy,which can maintain the stability of signs in dialysis,reduce blood pressure fluctuations,reduce the risk of hypotension in dialysis

关 键 词：维持性血液透析 低血压 血容量监测 米多君 平均动脉压 

分 类 号：R692[医药卫生—泌尿科学]