慢性肾功能衰竭血液透析低血压变化临床分析

Clinical Analysis of Intradialytic Hypotension Changes in Chronic Renal Failure Patients

目的探讨慢性肾功能衰竭患者血液透析时低血压的原因及防治。方法选择50例血液透析低血压者(低血压组),与50例无低血压患者(对照组)进行相关因素比较,并对低血压组的治疗进行分析。结果 50例慢性肾功能衰竭患者共进行血液透析4082例次,发生低血压441例次发生率为10.8%,低血压组与对照组对比,透析间期体重增长率、超滤量(FUV)及超滤率(FUR)较高(P<0.05);而血钠、血红蛋白(Hb)、血浆白蛋白(Alb)、血肌酐(Scr)及尿素氮(BUN)较低(P<0.05)。结论血液透析中发生低血压其主要原因为体液超滤过多过快、营养不良,心功能不全等,一旦出现应早期发现,及时治疗,立即处理低血压,防止严重并发症发生以提高透析效果,提高透析患者的生存质量。

Objective To explore the causes, treatment and prevention of IDH （intradialytic hypotension） in chronic renal failure patients. Methods Related factors were compared between 50 cases with IDH （IDH group） and 50 cases with non-intradialytic hy- potension （control group）. And the treatment given to the IDH group was analyzed. Results 50 cases with chronic renal failure were given 4 082 times of hemodialysis, in which intradialytic hypotension occurred 441 times（10.8%）. Compared with the control group, during hemodialysis, the IDH group had higher body weight increasing rate, FUV, FUR （P〈0.05） and lower serum Na＋, Hb, Alb, Scr, and BUN （P〈0.05）. Conclusion The main causes of IDH were biological fluids ultrafihration too much and too fast, malnutri- tion, cardiac insufficiency and so on. Therefore, once the IDH appeared, it should be discovered as early as possible and treated timely, the hypotension should be treated immediately, serious complications should be prevented so as to improve the hemodialy- sis effect and enhance the patients＇ quality of life.