肺部超声在改善尿毒症血液透析低血压中的临床应用  

Clinical application value of lung ultrasound for improving hypotension during hemodialysis in uremia

作　　者：谢丽红 谢祖刚 陈晓海 XIE Lihong;XIE Zugang;CHEN Xiaohai(Department of Nephrology,Longyan People's Hospital,Longyan,Fujian364000,China)

机构地区：[1]福建省龙岩人民医院肾病学科,龙岩364000

出　　处：《福建医药杂志》2025年第3期19-23,共5页Fujian Medical Journal

基　　金：龙岩市科技计划项目(2023LYF17019)。

摘　　要：目的探讨肺部超声监测及干预在改善尿毒症血液透析低血压中的作用。方法选择2023年1-12月于福建省龙岩人民医院血液透析中心行维持性血液透析治疗期间低血压发生率高的患者48例,随机分为对照组和观察组,每组各24例,对照组发生透析低血压时进行常规干预,观察组除常规干预外,采用肺部超声干预超滤量及干体重进行维持性血液透析治疗。3个月后统计两组患者干预期间透析低血压的发生率、单次透析时长以及透析前后血压,比较两组患者低血压发生率、单次透析时长及收缩压差、舒张压差、平均动脉压差。结果干预3个月期间,观察组透析低血压发生率低于对照组,差异有统计学意义(P<0.05)。干预3个月,观察组收缩压差、舒张压差、平均动脉压差均小于对照组,差异有统计学意义(P<0.05);观察组单次透析时长较对照组明显增加,差异有统计学意义(P<0.05)。结论肺部超声监测及干预可有效降低血液透析患者的透析低血压发生率,延长单次透析时长,提高透析充分性。Objective To explore the role of lung ultrasound monitoring and intervention in improving hypotension during hemodialysis in patients with uremia.Methods Forty-eight patients with a high incidence of hypotension during hemodialysis,who underwent maintenance hemodialysis at the Hemodialysis Center of Longyan People's Hospital in Fujian Province from January to December 2023,were selected and randomly divided into a control group and an observation group,with 24 patients in each group.When hypotension occurred during hemodialysis,the control group received routine interventions,while the observation group,in addition to routine interventions,used lung ultrasound to adjust the ultrafiltration volume and dry weight during maintenance hemodialysis.After three months,the incidence of hypotension during hemodialysis,the duration of a single hemodialysis session,and blood pressure before and after hemodialysis were recorded for both groups.The incidence of hypotension,the duration of a single hemodialysis session,and the differences in systolic blood pressure,diastolic blood pressure,and mean arterial pressure between the two groups were compared.Results During the 3-month intervention period,the incidence of hypotension during hemodialysis in the observation group was lower than that in the control group,with a statistically significant difference(P<0.05).During the 3-month intervention period,the differences in systolic blood pressure,diastolic blood pressure,and mean arterial pressure in the observation group were smaller than those in the control group,with statistically significant differences(P<0.05).During the 3-month intervention period,the duration of a single hemodialysis session in the observation group was longer than that in the control group,with a statistically significant difference(P<0.05).Conclusion Lung ultrasound monitoring and intervention can effectively reduce the incidence of intradialytic hypotension in hemodialysis patients,prolong the duration of a single hemodialysis session,and enhance dialys

关 键 词：维持性血液透析 肺部超声 透析低血压 

分 类 号：R459.5[医药卫生—治疗学]