不同透析模式对老年血液透析低血压的影响及护理对策

The effect of different modes of dialysis hypotension in elderly hemodialysis and its nursing countermeasures

目的:探讨不同透析模式对老年血液透析低血压的影响。方法:选择2006年7月～2011年7月在血液透析中经常出现低血压反应的23例患者为研究对象。对研究对象进行常规血液透析治疗10次(对照组)后,再分别接受3种不同的血液透析模式,即单纯超滤+血液透析(试验组A),钠梯度血液透析(试验组B)和钠梯度+超滤梯度血液透析(试验组C),每种模式分别进行10次。比较透析过程中低血压的发生情况。结果:单纯超滤+常规血液透析模式的患者低血压发生情况与一般常规血液透析相比较无显著差异(P>0.05);钠梯度血液透析模式的患者低血压发生情况显著低于一般常规透析模式(P<0.05);钠梯度+超滤梯度血液透析模式的患者低血压发生情况显著低于一般常规透析模式(P<0.05)。结论:在临床中,对于血液透析过程反复发生低血压的患者可首选钠梯度+超滤梯度血液透析或钠梯度血液透析。

Objective ：To compare the effect of different dialysis mode on hypotension of eldery hemcdialysis patients. Methods ：To select 23 patients from Ju ly 2006 to July 2011 who appear frequently in hemodialysis hypotension. On routine HD treatment study 10 times, and then were treated with three different HD model, that is pure UF ＋ HD test group A, HD sodium o＇adient（test group B）and sodium gradient ＋ UF gradient （test group C）. 10 times for each mode separately. 4 during dialysis compared the incidence of hypotension. Results：Through three different modes of dialysis patients the incidence of hypo tension compared with the normal routine dialysis, a simple conventional ultrafiltration ＋ HD mode of occurrence of hypoteusion in patients with no signifi cant difference （ P 〉 O. 05 ）. Sodium gradient in patients with hypotension in HD mode was significantly lower than normal conventional dialysis mode （ P 〈 0.01 ） ;Sodium gradient ＋ gradient uhrafiltration in patients with hypotension in HD mode was significantly lower than normal conventional dialysis mode （ P 〈 0.01 ）. Conclusion In the clinic, the process repeated for hemodialysis patients with hypotension may be the preferred sodium gradient ＋ gradient ul trafiltration or sodium gradient HD.