老年尿毒症患者血液透析中低血压的原因分析及护理对策

Causes and nursing on hemodialytic hypotension of senile patients with uraemia

目的探讨老年尿毒症患者血液透析中低血压的原因和护理对策。方法选择20例透析中低血压的老年患者（低血压组）与20例无低血压的老年患者（对照组）进行相关因素比较，并观察阶梯状钠模式（SP）和阶梯状超滤模式（UP）、标准透析（SD）在血液透析中低血压的发生情况。结果低血压组与对照组相比超滤量（UFV）增加（P〈0．05）；血钠、血浆白蛋白降低（P〈0．05）；尿素氮（Bun）和肌酐（Cr）差异不显著（P〉0．05）；3种透析模式中，发生低血压的例数UP与SD相比无差异（P〉0．05），SP与SD相比明显降低（P〈0．01）。结论透析中低血压是由多种因素造成的，对老年血液透析患者应该具体分析病情，采用个体化透析及护理对策。

Objective To discuss the causes and nursing on hemodialytic hypotension in the senile patients with uraemia. Methods 20 senile patients with hemodialytic hypotension （hypotension group） were compared with 20 senile patients without hemodialytic hypotension （control group）. The incidence of hemodialytic in hypotenslon radient sodium profiling （SP） and gradient ultrafiltration profiling （UP） and standard dialysis （SD） was observed. Results The ultrafiltration volume （UFV） of hypotension group was higher and serum natrium （Na） and albumin （ALB） were lower than those in control group （P 〈 0. 05）. However, there were no significant differences in blood urea nitrogen （Bun） and creatinine （Cr） between two groups （P 〉0.05）. Among three hemodialytic models, there was no significant difference in the occurring rate of hemodialytic hypotension between SD and UP （P〉0. 05）, but there was significant difference between SD and SP （P 〈0.01）. Conclusions Hemodialytic hypotension is caused by many factors. We should make concrete analysis to choose individual dialysis model and nursing for the senile patients.