维持性血液透析患者低血压发生的原因分析及护理

Correlative factors of hypotension and nursing interventions to maintenance hemodialysis patients

目的探讨维持性血液透析患者低血压发生的原因,并提出相应的护理对策。方法通过查阅病历,回顾性分析和总结49例血液透析患者发生低血压的原因。结果 49例血液透析患者,发生低血压的主要原因分别为:脱水量大(超过5%干体重)或脱水速度过快,营养不良或低蛋白血症,严重贫血,自主神经功能紊乱,钠浓度低或透析液温度高,透析前透析中用药或透析中进食过饱。结论有效控制患者的每日体重增长,正确评估干体重,做好低温度透析与曲线钠浓度透析,对预防维持性血液透析患者低血压发生具有重要意义。

Objective To explore the correlative factors of hypotension among hemodialysis patients and to come up with nursing interventions. Methods The histories of 49 maintenance hemodialysis patients were retrospectively reviewed to find out the correlative factors of hypotension and summarize the nursing strategies. Results The major factors for hypotension included large volume of dehydration and fast speed of dehydration in 22 cases, malnutrition and hypoproteinemia in 8 cases, severe anemia in 6 cases, dysfunction of the autonomic nervous system in 5 cases, low concentration of sodium or high temperature of dialysate in 4 case and medication errors and eating too much before or during dialysis in 4 cases. Conclusion The nursing strategies including control of weight, correct assessment of dry weight, right performance of low temperature hemodialysis and sodiun profile hemodialysis as well as mental care to those with depression are critical for prevention of hypotension development in patients undergoing maintenance hemodialysis.