低温透析在儿童血液透析中的应用

The application of lower temperature dialysate for hemodialysis in children

目的观察低温透析在儿童血液透析中的应用。方法选择首都医科大学附属北京儿童医院的急慢性透析患儿,分别进行常温透析(37℃)和低温透析(35℃),共95人次。比较透析中血压、心率及低血压发生率的变化。结果在透析第3h低温透析组舒张压水平明显高于常温透析组(P=0.023);与透析前基础血压相比,常温组舒张压和平均动脉压下降程度较低温组更显著,透析进行到第3h两组间均具有显著差异(分别为P=0.004和P=0.014)。在透析结束时,低温组具有稳定心率的优势,两组间有统计学意义(P=0.032)。在低血压发生率和透析效率方面无有统计学意义。结论低温透析在儿童中同样适用,可以有效维持透析中患儿血流动力学稳定。

Objective To observe the effect of lower temperature dialysate for hemodialysis in children.Methods We analyzed 95 times of hemodialysis using 37℃ dialysate or 35℃ dialysate for children with acute or chronic renal failure.Their blood pressure,heart rate and the incidence of hypotension were compared.Results After hemodialysis for 3 hours,the children treated with 35℃ dialysate showed higher diastolic blood pressure than those treated with 37℃ dialysate（P=0.023）.The decrease of diastolic and mean blood pressure was greater in children treated with 37℃ dialysate than in those with 35？ dialysate,and these differences became more apparent after the hemodialysis for 3 hours.In children treated with 35℃ dialysate,heart rate was relatively stable（P=0.032）,but without the advantages in hypotension incidence and dialysis efficiency.Conclusion Lower temperature hemodialysate is better in maintaining hemodynamic stability,and is also suitable for children.