维持性血液透析患者个体化透析液钠离子浓度效果观察

Observation of Clinical Effects of Individualized Sodium Concentration Dialysate on Maintenance Hemodialysis Patients

目的探讨采用个体化透析液钠离子浓度进行血液透析对维持性血液透析患者常用临床指标和透析不良反应发生情况的影响。方法选择透析中心维持性血液透析患者100例,先给予常规血液透析治疗8周,透析液钠离子浓度均设为140mmol/L;再根据患者病情选择个体化的透析液钠离子浓度治疗8周。比较2个阶段治疗结束后患者血压、体质量、血清尿素氮、肌酐、红细胞压积、Kt/V值等指标的变化和透析过程中不良反应的发生情况。结果患者经2个阶段治疗后,各临床指标变化差异无统计学意义,但个体化透析治疗期间患者在透析过程中低血压和高血压的发生率显著降低(P<0.05),而透析过程中低血糖、肌肉抽搐、心律失常、心力衰竭和透析失衡等不良反应发生率差异无统计学意义。结论个体化透析液钠离子浓度可有效减少维持性血液透析患者的不良反应,特别对透析过程中患者的血压具有良好的稳定作用。

Objective To explore the influence of individualized sodium concentration dialysate on the incidence of common clinical indexes and adverse reactions in maintenance hemodialysis patients. Methods 100 maintenance hemodialysis patients were included as the subjects for this study. First, they were offered an 8-week conventional hemodialysis with the sodium concentration being 140 mmol/L. Then in the second stage, they were given an 8-week hemodialysis with individualized sodium concentration in light of the specific condition of the disease. Comparisons were made of the changes in the patients＇ blood pressure, body mass, hematocrit, serum creatinine, serum urea nitrogen and Kt/V, and the incidences of adverse reactions during the hemodialysis at the end of the two stages. Results There was no statistically significant difference in clinical indexes between the two stages. But the incidence rates of hypertension and hypotension during the second stage were distinctly lower （P〈0.05）, while the difference in the incidence rate of other adverse reactions such as hypoglycemia, muscle jerk, arrhythmia, heart failure and dialysis dysequilibrium had no statistical significance. Conclusion Individualized sodium concentration dialysis can effectively lower the incidence rate of adverse reactions among maintenance hemodialysis patients, having a good effect of stabilizing the blood pressure during the dialysis.