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不同透析模式预防血液透析中低血压效果的研究 被引量:3

Study on the effects of different patterns of dialysis in prevention of hemodialysis-associated hypotension
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摘要 目的比较几种不同的血液透析模式对血液透析中低血压的预防作用。方法选择2003年2月—2005年12月在血液透析(hemodialysis,HD)中经常出现低血压反应的规律HD患者14例研究对象,采用单盲法,自身对照设计。常规HD治疗8次后,再分别接受3种不同的透析模式,即单纯超滤+HD,钠梯度HD和钠梯度+超滤梯度。每种模式持续8次。比较3组患者透析过程中低血压的发生情况。结果钠梯度HD和钠梯度+超滤梯度HD组低血压发生率与常规HD相比,每种透析模式透析前血压比较差异无统计学意义(P>0.05);钠梯度+超滤梯度HD透析结束血压、透析过程最低血压与透析前血压的差值与常规HD、单纯超滤+HD以及钠梯度HD相比较,差异有统计学意义(P<0.05)。单纯超滤+HD预防低血压作用不明显(P>0.05)。结论本研究提示对于血液透析过程反复发生低血压的患者应首选钠梯度+超滤梯度HD,其次钠梯度HD。 Objective To compare the effects of four dialysis patterns in prevention of hypotension during hemodialysis(HD). Methods Forteen cases of maintenance hemodialysis patients who had episodes of hypotension during hemodialysis were enrolled for study by single blind self-control design. After 8 times of routine HD, 3 other patterns of dialysis were employed for the same patient in succession, each for 8 times. Pattern 1 : Ultrafihration plus HD : single uhrafiltration for 30 minutes followed by 4-hour routine HD ; Pattern 2 : Natrium gradient HD : natrium concentration in dialysate between 135 - 150 mmol/L: Pattern 3: Natrium gradient plus ultrafihration gradient HD. Results Compared with routine HD, the occurrence of hypotension and frequency of nursing interference were declined remarkably in pattern 2 and 3 (P 〈 0.01 ). There was no significant difference in blood pressure before the use of each pattern of dialysis ( P 〉 0. 05). The difference of blood pressure before dialysis and that at the end of dialysis or the lowest blood pressure during dialysis by pattern 3 had statistical significance (P 〈 0. 05), compared with that of routine HD, pateern 1 and 2. Pattern 1 was noticeably ineffective in the prevention of hypotension during hemodialysis ( P 〈 0. 05). Conclusion For patients who suffered from frequent attacks of hypotension during hemodialysis, the pattern of natrium gradient plus uhrafiltration gradient HD (pattern 3) to be the first choice seemed and natrium gradient HD (pattern 2) the second in treatment. Single ultrafihration plus HD ( patten 1 ) has no obvious effect in prevention of hypotension during hemodialysis.
出处 《上海护理》 2007年第4期7-9,共3页 Shanghai Nursing
关键词 血液透析 低血压 预防 Hemodialysis Hypotension Prevention
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