连续性肾替代疗法在老年患者血液透析时低血压治疗中的应用

Clinical experience in continuous renal replacement therapy used in hypotension of the elderly hemodialysis

目的评估连续性肾替代疗法(continuous renal replacement therapy,CRRT)在老年患者血液透析中持续低血压时的救治效果。方法对我院2002年1月～2007年12月间老年血液透析患者中32例发生透析中低血压者应用Prisma机进行CRRT治疗。结果32例均采用CRRT治疗1～5次,每次治疗时间5.0～7.5h。除2例因血压不稳定且合并其他并发症死亡,1例血管条件差历经瘘闭再造瘘、静脉穿刺插管均失败和1例经CRRT治疗仍透析中反复低血压转为腹膜透析外,其余28例均纠正了低血压,转为正常透析,且血压平稳。结论CRRT治疗可以稳定老年透析患者的心血管功能,改善患者的内环境。

Objective Evaluation of continuous hypotension in the elderly hemodialysis treated by continuous renal replacement tberapy（CRRT）. Methods In 2002-2007,32 hypotension complicated by hemodialysis in the elderly were treated by CRRT used in Prisma 1-5 times. Results After the patients were treated by CRRT, 2 cases died because of unstable blood pressure and other complications. 1 case of the occlusion of internal arteriovenous fistula under the worse vessel conditions and 1 case repeat hypotension after CRRT were instead of peritoneal dialysis. The normal hemodialysis was recovered in 28 patients. Conclusions CRRT can stable the heart function of the elderly hemodialysis, balance and improve internal environment.