环硅酸锆钠散治疗血液透析患者高钾血症的效果  

Effect of Sodium Zirconium Cyclosilicate Powder on Hyperkalemia in Hemodialysis Patients

作　　者：白斌[1] 郑喜胜[1] 冯永利[1] 肖京[1] 赵聪源 左方田 BAI Bin;ZHENG Xisheng;FENG Yongli;XIAO Jing;ZHAO Congyuan;ZUO Fangtian(Department of Critical Care Medicine,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院重症医学科,河南南阳473000

出　　处：《河南医学研究》2025年第5期907-911,共5页Henan Medical Research

摘　　要：目的研究环硅酸锆钠散治疗血液透析患者高钾血症的效果及对血钾、血钠及血红蛋白水平的影响。方法前瞻性选择2022年1月至2023年2月入南阳市中心医院接受血液透析治疗出现高钾血症的86例患者为本次研究的人群,按照随机分组方式分为研究组(43例)和对照组(43例)。对照组患者以静脉输注的方式接受常规的降钾治疗手段,研究组接受环硅酸锆钠散的治疗方式。分析治疗前后两组患者的治疗效果及血钾浓度、电解质水平、心率和血压变化及不良事件发生情况等。结果治疗后,研究组和对照组患者的临床治疗有效率分别为95.35%(41/43)和76.74%(33/43),差异有统计学意义(P<0.05)。两组患者的血钾水平均呈现下降趋势,两组患者组间、不同时间点及交互作用有统计学意义(P<0.001)。研究组患者的舒张压和收缩压均低于对照组(P<0.05)。研究组患者不良事件发生率为6.98%(3/43),对照组不良事件发生率为20.93%(9/43),差异无统计学意义(P>0.05)。结论相较于静脉输注的降钾治疗手段,环硅酸锆钠散可以有效治疗患者的高钾血症,平衡机体电解质水平,同时不引入新的不良事件,患者接受度更高,值得广泛应用于血液透析患者的高钾血症治疗。Objective To study the effect of sodium zirconium cyclosilicate powder on hyperkalemia in hemodialysis patients and its influence on blood potassium,blood sodium and hemoglobin levels.Methods Prospective selection of 86 patients with hyperkalemia admitted to Nanyang Central Hospital for hemodialysis treatment from January 2022 to February 2023 as the study population,and divided them into the study group(43 cases)and the control group(43 cases)according to the random grouping method.The patients in the control group received routine potassium lowering therapy by intravenous infusion,while the patients in the study group received sodium zirconium cyclosilicate powder.The treatment efficacy,blood potassium concentration,electrolyte levels,changes in heart rate and blood pressure,and incidence of adverse events of the two groups of patients before and after treatment were analyzed.Results After treatment,the clinical treatment efficacy rates of the study group and the control group were 95.35%(41/43)and 76.74%(33/43),respectively,the difference was statistically significant(P<0.05).The blood potassium levels of both groups of patients showed a downward trend,the differences in interaction between the two groups of patients at different time points and between groups were statistically significant(P<0.001).The diastolic and systolic blood pressure of the study group patients were lower than those of the control group(P<0.05).The incidence of adverse events in the study group was 6.98%(3/43),while the incidence of adverse events in the control group was 20.93%(9/43),the difference was not statistically significant(P>0.05).Conclusion Compared with intravenous infusion of potassium lowering therapy,sodium zirconium cyclosilicate powder can effectively treat patients with hyperkalemia,balance the body electrolyte level.At the same time,it does not introduce new adverse events,and patients have higher acceptance.It is worth widely applying to the treatment of hyperkalemia in hemodialysis patients.

关 键 词：血液透析 高钾血症 环硅酸锆钠散 血钾水平 疗效 

分 类 号：R459.5[医药卫生—治疗学]