36例血透治疗肾衰并酸中毒及高钾血症的临床分析

Clinical analysis of 36 cases hemodialysis in treatment of uremic patients complicated with severe acidosis and hyperkalemia

目的观察血液透析治疗慢性肾功能衰竭伴严重代谢性酸中毒及高钾血症的疗效。方法对36例血pH值<7.0的慢性肾功能衰竭患者采用血液透析,透析前给予补充碳酸氢钠和钙剂,对血压明显降低者给予升压治疗,对存在呼吸障碍者给予呼吸机辅助呼吸。结果患者行血液透析后血pH值及开始上升,血钾逐渐下降,透析结束时各值均达到基本正常范围。结论血液透析能够迅速纠正慢性肾功能衰竭患者严重代谢性酸中毒及高钾血症。

【Objective】 To investigate the effect of hemodialysis for uremic paticnts complicated with severe metabolic acidosis and and hyperkalemia.【Methods】 Bicarbonate hemodialysis was applied for 36 uremic patients with acidosis（pH7.0）.Calcium was supplied before hemodialysis.Blood pressure adjustment were performed for patients with hypopiesis.Breathing machines were served in treatment of patients with respiratory distress.【Results】 Plasma pH and concentra-tion of bicarbonate began to rise;Serum potassium concentration gradually decreased after hemodialysis.Plasma pH,serum potassium reached normal level at the end of hemodialysis.【Conclusion】 Hemodialysis may correct severe metabolic acidosis and hyperkalemia in uremic paticnts rapidly.