糖尿病肾病患者血透过程中血压变化特点及护理对策

Analysis of characteristics of blood pressure change in patients with diabetic nephropathy during hemodialysis and nursing countermeasure

目的分析糖尿病肾病患者血透过程中血压变化特点,提高血压监测及控制的质量。方法选择血透6月以上的糖尿病肾病患者（DN组,n=12）和同时期慢性肾炎尿毒症患者（CGN组,n=40）,测量血透前基础血压及血透0 h、1 h、2 h、3 h血压,计算各时段血压变化值;进一步将DN组分为老年组（≥65岁,n=7）和非老年组（〈65岁,n=5）,分析其血压变化特点。结果DN组血透中低血压发生率为33.3%,显著高于CGN组（P〈0.01）;2组间血透各时段血压变化有显著性差异（P〈0.001）;老年DN组血透中低血压发生率为47.6%,高于非老年组（P〈0.05）,但2组间血透各时段血压变化无显著性差异（P〉0.05）。结论糖尿病肾病患者血透过程中血压下降幅度大、速度快;老年糖尿病者更易于出现血透中低血压,在血透时更需要加强血压监测及控制。

Objective To explore the characteristic of the change of blood pressure of patients with diabetic nephropathy（DN） during hemodialysis in order to promote the nursing quality.Methods 12 DN patients who underwent hemodialysis more than 6 months（DN group） and 40 non-DN patients（CGN group） were divided randomly into two groups.Their blood pressure was monitored before hemodialysis and at 0h,1h,2h, 3h during hemodialysis.Then the patients in DN group were divided into senile group（≥65 year-old,n=7） and adult group（〈65 year-old,n=5） and the change of blood pressure of two groups were analyzed.Results The incidence of hypotension in DN group was 33.3%,which was higher than that in CGN group（P〈0.01）;and there was significant difference in the change of blood pressure between DN group and CGN group（P〈0.001）.The incidence of hypotension in senile group was 47.6%,which was higher than that in adult group（P〈0.05）,but there was no significant difference in the change of blood pressure between two groups（P〉0.05）.Conclusions DN patients,especially senile DN patients,are prone to suffer low blood pressure than non DN patients.More observation is required for them during hemodialysis.