血液透析中进食时间对患者血压的影响分析

Effect of the eating time on blood pressure of patients during hemodialysis

目的:探讨血液透析过程中进食时间对患者血压的影响。方法:选择在透析时出现低血压的维持性血液透析患者25例,采用自身对照方法,按不同进食时间,分别给予透析中禁食、透析2 h内进食及透析3 h后进食,进食量约250 g。每种方法观察2周,记录每次进食前和进食后30 min平均动脉压,透析前及透析中每小时平均动脉压,并进行比较。结果:3组患者进食前后平均动脉压差、透析前平均动脉压和透析中最低平均动脉压差及3组患者低血压、症状性低血压发生率及护理干预情况差异均有统计学意义(P<0.01),3 h后进食组各项指标与其余2组差异有统计学意义(P<0.01)。3组患者透析前平均动脉压及发生透析相关性低血压停止透析的例次差异均无统计学意义(P>0.05)。结论:有低血压倾向的患者,应选择在透析2 h内进食,避免在透析3 h后进食,有助于预防透析中低血压的发生。

Objective： To explore the effects of the eating time on blood pressure of patients during hemodialysis. Methods： The clinical data of 25 patients with hypotension during hemodialysis were investigated using self-control method. The patients were treated with fasting during hemodialysis,eating 250 g food within 2 h of hemodialysis and at 3 h after hemodialysis for 2 weeks,respectively. The mean arterial pressure at 30 min before and after eating,and every hour mean arterial pressure before the hemodialysis and during hemodialysis were analyzed. Results： The differences of mean arterial pressure before and after eating and before the hemodialysis and during hemodialysis,the occurrence rates of hypotension and symptomatic hypotension,and nursing intervention between 3 groups were statistically significant（ P〈0. 01）. The differences of all indexes of patients treated with eating at 3 h after hemodialysis and other two groups were statistically significant（ P〈0. 01）. The differences of mean arterial pressure before the hemodialysis and number of stop hemodialysis caused by hypotension between 3 groups were not statistically significant（ P〉0. 05）. Conclusions： For hypotension-prone patients,the eating time should be within 2 h hours of hemodialysis,and prohibit at 3 h after hemodialysis,which can prevent the hypotension.