血液透析中低血压的发生原因及对策

Causes and countermeasures of low blood pressure during hemodialysis

目的分析血液透析(hemodialysis,HD)治疗慢性肾功能衰竭(chronicrenalfailure,CRF)中低血压的发生原因及对策。方法总结2003年1月～2005年6月血液透析治疗中低血压的防治经验。结果3025次血透中发生低血压463次,引起低血压的原因包括:过量脱水250次(54.0%),重度贫血148次(32.0%),心力衰竭51次(11.0%),低蛋白血症9次(1.9%),感染、发热5次(1.1%)。经过积极救治,所有低血压均获得成功纠正。结论针对透析低血压的发生原因和病理机制采取相应的措施,可有效降低其发生率,保证血液透析治疗的施行和效果,进而改善慢性肾衰患者的预后。

[Objective] To analyse the causes and countermeasures of low blood pressure during hemodialysis in treatment of chronic renal failure （CRF）. [Methods] To summarize the experience of preventing and treating low blood pressure during hemodialysis from Janurary 2003 to June 2005. [Results] Of 3 025 hemodialysis, the occurring frequency of low blood pressure was 463 and its causes included as follows： the frequency of excessive dehydration was 250（54.0%）, heavy anaemia 148（32.0%）, heart failure 51 （11.0%）, low plasma albumen 9（1.9%）, infection and fever 9（1.9%）. The low blood pressure was successfully corrected by positive treatment. [ Conclusions] Certain relevant measures can be taken to control low blood pressure in allusion to its causes and pathological mechanism, to reduce its occurring rate effectively and ensure hemodialysis implemented and effectual, further improve the prognosis of the patients with CRF.