低温配合可调钠透析模式对血液透析患者低血压的影响

THE EFFECTS OF HYPOTHERMY AND ADJUSTABLE SODIUM DIALYSIS ON HYPOTENSION OF PATIENTS RECEIVING HEMATODIALYSIS

目的探讨透析液温度、钠浓度对透析中低血压的影响及护理方法。方法选择在维持性血液透析过程中容易发生低血压的患者9例,采用自身交叉对照的方法,分别进行10次常规透析(透析液温度37℃、恒定钠浓度138 mmol/L)和10次低温+可调钠透析(透析液温度35.5℃、可变钠浓度135～146 mmol/L),透析过程中监测平均动脉压、血压、血清钠浓度及超滤量、透析后体重增长情况。结果低温+可调钠透析模式较常规透析模式平均动脉压有明显提高(P<0.05),低血压发生次数明显减少(P<0.05)。结论采用低温+可调钠透析模式能有效减少透析过程中低血压的发生,提高患者的生存质量。

Objective To explore the effects of dialysate temperature and sodium density on hypotension and correlative nursing methods. Methods Cross-reference was used for 9 cases who were likely to suffer from hypotension in the maintenance dialysis by means of 10 times of routine dialysis with the temperature being 37℃ and the constant sodium density being 138 mmol/L and 10 times of the combined use of hypothermy and adjustable sodium dialysis with the temperature being 35.5℃ and the adjustable sodium density being 135-146 mmol/L. The mean arterial blood pressure, the blood pressure, the density of ultrafiltrate and the weight increase after dialysis were monitored in the process of dialysis. Results When compared with the standard dialysis, the therapy of hypothermy and adjustable sodium dialysis produced increased mean arterial blood pressure （MABP）（ P〈0. 05）and reduced times of hypotension（ P 〈0. 05）. Conclusion The therapy of hypothermy and adjustable sodium dialysis can obviously reduce the incidence of hypotension. It can promote the survival of patients receiving dialysis.