甘露醇预防血液透析相关低血压临床研究

Prevention of dialysis-associated hypotension with mannitol

目的探讨甘露醇注射液预防血液透析相关性低血压的适应症、使用方法和临床效果。方法选择血液透析中经常发生低血容量性低血压的患者40例，随机分为研究组与对照组，每组20例。研究组透析1h后静滴甘露醇150ml，对照组同一时间开始给予0．9％氯化钠注射液150ml，透析最后1h之前停止使用两种药物。结果研究组透析中低血压发生率（7％）显著低于对照组（48％），同时透析间期急性左心衰竭发生率（5％）也显著低于对照组（30％）。结论甘露醇注射液能降低血液透析相关性低血压的发生率，更容易达到目标超滤量，并因此减少透析间期急性左心衰竭的发生率。

Objective To explore the indication, application and clinical effect of mannitol in preventing dialysis-associated hypotension. Methods Forty hypotension-prone patients on maintenance hemodialysis were randomly divided into study group and control group（n = 20 in each group）. The patients in the study group were intravenously injected with 20% mannitol（ 150 ml） 1 h after the start of dialysis,and those in control group were administrated 0. 9% normal sodium（151） ml） at the same time. The treatments were withdrawn l h before the end of dialysis. Results The incidence of hypotension during hemodialysis（7%）in study group was significantly lower than that（48%）in control group. Meanwhile the incidence of interdialytic acute congestive heart failure in study group（5 % ）was significantly lower than that（30%）in control group. Conclusions Intravenous drip of mannitol can effectively prevent dialysis-associated hypotension and easily achieve goal uhrafihration volume in hemodialysis, and reduce the incidence of acute congestive heart failure during dialysis.