低温联合可调钠治疗模式对老年透析低血压的疗效观察

Efficacy Observation of Microtherm in Combination with Adjustable Sodium Concentration on Hypotension Due to Dialysis in Elderly People

目的观察低温联合可调钠治疗模式对老年透析低血压的治疗效果。方法观察10例老年血液透析患者治疗16周共480例次,其中前8周(设为对照组,240例次)采用恒定钠浓度138mmol/L,透析液温度37.0℃;后8周(设为治疗组,240例次)采用低温(35℃～36.0℃),透析液钠浓度在透析治疗中前200份设定为148mmol/L,后40份调整为136mmol/L。观察治疗组与对照组患者透析中血压、血钠、体温、脱水量、低血压发生率、透析体重未达标率及患者的耐受情况。结果治疗组透析前平均动脉压与透析中最低平均动脉压的差值、低血压发生率、体重未达标率均明显低于对照组(P<0.05),且患者耐受性好。结论低温联合可调钠治疗模式能有效防治老年透析低血压,值得临床推广应用。

Objective To observe the effect of microtherm in combination with adjustable sodium concentration on hypotension due to dialysis in elderly people.Methods 10 elderly patients undergoing dialysis within 16 weeks in total of 480 person times were observed.Of them,in the first 8 weeks（designed to be control group,240 person times）,the constant sodium concentration was138 mmol/L and the temperature of dialysate was 37.0℃.In the last 8 weeks（designed to be observation group,240 person times）,the microtherm（35~36.0℃）was adopted.The sodium concentration in dialysate was designed as 148 mmol/L for the first 200 person times and it was adjusted as 136 mmol/L in the later treatment of 40 person times.It was to observe blood pressure,plasma sodium,body temperature,dehydration level and incidence of hypotension,non-meeting rate of standard weight after dialysis and the tolerance of patients in dialysis.Results The mean arterial pressure before dialysis and the difference of the lowest mean arterial pressure during dialysis,the incidence of hypotension as well as non-meeting rate of standard weight in treatment group were all inferior to those in control group.Additionally,the patient＇s tolerance was satisfactory.Conclusion The effect of microtherm in combination with adjustable sodium concentration can prevent from hypotension in dialysis for elderly people and this therapy deserves promoting in clinic.