老年病人维持性血液透析中心律失常的观察及护理

Observation and Nursing of Elderly Patients with Arrhythmia During the Maintenance Hemodialysis

目的探讨老年病人维持性血液透析中心律失常的原因及护理措施。方法回顾性分析42例老年病人2368例次血液透析中334例次心律失常病例资料,并分析其原因,制定相应的护理措施。结果心律失常发生率为14.1%,有原发心脏病者较无心脏病者发生率高,发生于透析开始2～5h者占74.3%。超滤脱水量>2kg以上时,心律失常发生率为56.6%。心律失常类型以心房纤颤、房性、室性早搏为多见。结论心律失常发生率与超滤脱水量成正比,低血压是其主要诱因,电解质紊乱、酸碱失衡也可引起心律失常的发生,积极采取相应的治疗护理措施可以有效地控制心律失常的发生,使血液透析顺利进行。

[Objective]To investigate the cause and nursing measures of arrhythmia in elderly patients during the maintenance hemodialysis.[Methods]Totally 334 cases of sub-clinical data of arrhythmia from 2368 cases of maintenance hemodialysis in 42 elderly patients were retrospectively analyzed.The cause of arrhythmia was analyzed,and the appropriate nursing measures were made.[Results] The incidence of arrhythmia was l4.1% in those cases.The incidence of arrhythmia of patients with primary heart disease was higher than that of patients without primary heart disease.74.3% of the arrhythmia happened in 2～5 hours after the beginning of hemodialysis.The incidence of arrhythmia during the hemodialysis was 56.6% when the ultrafiltration volume was greater than 2kg.Atrial fibrillation,atrial,ventricular premature beats were common.[Conclusion]The arrhythmia during the hemodialysis is positively related to the ultrafiltration volume.Hypotension is the main incentive,and electrolyte disorders,acid-base imbalance may also cause the occurrence of arrhythmia.To take the appropriate treatment and care measures can effectively control the occurrence of arrhythmia,so that hemodialysis is conducted smoothly.