慢性肾衰患者血液透析并发心律失常的临床疗效分析

Study on the Clinical Treatment of Chronic Hemodialysis Patients with Renal Failure Complicated by Arrhythmia

目的:探讨血液透析治疗慢性肾衰患者并发心律失常的临床疗效。方法:共选择50例血液透析治疗慢性肾衰竭并发心律失常的患者作研究对象,均为我院2010年5月至2013年5月收治,依据临床特点制定治疗措施。结果:本组选取病例中,共行血液透析520例次,心律失常105例次,其中心房颤动24例次,室上性早搏31例次,窦性心动过缓2例次,室上性心动过速1例次,室性早搏二联律23例次,室性早搏24例次。各年龄段心律失常发生率有统计学差异(P<0.05),年龄与心律失常发生率呈正相关。临床胺碘酮药物起效时间为(14±8)min,治疗总有效率为92%,窦性心律转复率为82%,出现浅静脉炎1例次,采用硫酸镁处理后缓解。结论:慢性肾衰患者采用血液透析治疗时,并发心律失常与多因素相关,需依据患者年龄、机体特点针对性防控,采用胺碘酮治疗,可提高临床救治效果,促使窦性心律转复,保障患者生命安全。

Objective To study the clinical treatment of hemodialysis in patients with chronic renal failure complicated by arrhythmia. Methods Total 50 cases of hemodialysis in the treatment of chronic renal failure patients complicated by arrhythmia were selected as the research object, who were treated on the basis of their clinical characteristics in our hospital from May 2010 to May 2013. Results The selected cases were carried out hemodialysis for total 520 times complicated by arrhythmia for 105 times including atrial fibrillation 24 times, supraventricular premature beats 31 times, sinus bradycardia 2 times, supraventricular tachycardia 1 time, ventricular premature beats bigeminy 23 times and ventricular premature beats 24 times. The differences of the incidence of arrhythmia in all ages were statistical（P〈0.05）. The incidence of arrhythmia was positively correlated with age. The clinical onset time of amiodarone drug is（14 ± 8） min, the total effective rate was 92 %, Sinus cardioversion rate was 82 %, with shallow phlebitis in 1 times which was relieved after the magnesium sulfate treatment. Conclusion When chronic renal failure patients were treated with hemodialysis, cardiac arrhythmias was complicated associating with multiple factors. The targeted prevention and control of its occurrence should be according to patient＇s age and body features. Amiodarone treatment can improve the clinical effect, promote sinus cardioversion, guarantee the safety of patients.