腹透患者低血压的原因及对策探讨

Hypotension in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis

目的:了解持续非卧床腹膜透析(CAPD)患者低血压的原因、对策及转归。方法:比较有低血压的CAPD患者与对照组的一般资料、营养状况、透析充分性、心脏功能、治疗和转归等。结果:低血压组与对照组在性别、年龄、透析时间、原发病的组成、血红蛋白、血白蛋白、肱三头肌皮肤皱褶厚度、尿素清除指数、血尿素氮和血清肌酐等方面无显著差异。低血压组的射血分数小于对照组。低血容量引起的低血压易纠正。低血压组的病死率高于对照组。结论:CAPD患者的低血压主要与低血容量、降血压药、心衰等有关,有效防治低血压的发生可以改善CAPD患者的预后。

Objective： To investigate the etiology, management and clinical outcome of the continuous ambulatory peritoneal dialysis （CAPD） patients with hypotension. Methods：The baseline data, nutrition, adequacy of dialysis, heart function, treatment and outcome of hypotensive patients were analyzed and compared with those of the nonhypotensives on CAPD. Results： There was no significant difference in gender, mean age, dialysis duration and primary disease between the two groups. The differences in hemoglobin, serum albumin, triceps skin fold, urea clearance index, serum creatinine and blood urea nitrogen between two groups were not significant. Left ventricular ejection Fraction of the hypotensive patients was less than that of the control group. The patients in the hypovolemic group responded well to treatment. The mortality rate of hypotensive patients was higher than that of the nonhypotensives on CAPD. Concision：For CAPD patients, hypotension is attributed to hypovolemia, heart failure, antihypartensive medications and other unclear causes. With effective prevention and cure of hypotension, the prognosis of CAPD patients can be improved.