血液透析中并发低血糖——76例次临床报告

Hypoglycemia in the course of hemodialysis

目的为提高对血液透析过程中并发低血糖的警觉和防治能力。方法对我院2006年1月至12月在本院接受常规维持血液透析患者57例，男36例，女21例，年龄16～86岁，共行血透4713次。透析时出现心慌、胸闷、眩晕、出汗、低血压、意识障碍表现患者836例次，以血糖仪监测透析器动脉端血糖。结果血糖〈3．0mmol／L患者76例次，男49例次，女27例次，年龄48～79岁，平均61岁，糖尿病和非糖尿病慢性肾衰竭患者分别为31例次和45例次，以50％葡萄糖注射液输入后症状缓解，除13例次患者因极度衰竭终止透析外，其余按计划完成血透。结论血液透析时患者产生低血压表现往往被认为是过度超滤，透析失衡，而低血糖容易被忽视，本组病例中占9％，对有上述临床表现者常规豁测血糖，有利于防止血液透析过程中低血糖诱发的严重医疗事件。

Objective To prevent the severe medical events caused by hypoglycemia occuring during course of hemodialysis. Method Fron Jamuary 2006 to December 2006 there were 57 patiants with a fotal of 4713 times on maintenance hemodialysis in our hospital. Among them 836 times developed sguptous of palpitation, chest destress, mental impairment, perspiration and hypotemison. By blood glucose control, when blood glucose 〈3. 0 mmol/L, hypoglycemia was diagnosed. Results 76 times of hypoglycemie attack were detecled with male 49 times, female 27 times, age range 48 - 79 years, aueroge of 61.31 Hypoglycemia attack occured in diabetic nephropathy with CRF, and 45 times in non-diabetic CRF. After infusion of 50% glucose solution,symptorus nesolued. In 13 times,henodialysis was terminated because of severe exhaustion of patieuts. The others completed heuodialysis according to plan. Conclusions Hypoglycemia during heuodialysis is liable to be neglected. For those who developed syuptous of hypoglycemia, blood glucors should be determiued in time, in order to prevent severe medical events induced by hypoglycemia.