无钾血液透析联合常规血液透析治疗透析前顽固性高钾患者临床观察

Postssium blood dialysis with regular hemodialysis therapy before dialysis patients with high potassium clinical observation

目的 观察无钾血液透析联合常规血液透析治疗透析前顽固性高钾患者临床疗效.方法 筛选保守治疗无效、透析前血钾＞6.0mmol/L的维持性血液透析患者48例,经本院伦理委员会批准及患者知情同意下均对其采用无钾血液透析（2h）联合常规血液透析（2h）的方式进行治疗,观察透析前后血钾的变化.结果 联合治疗1个月后患者透析前血钾浓度由（6.30±1.10） mmol/L降至（5.05±1.00） mmol/L,差异较为明显;联合治疗过程中钠离子（140.00±3.80） mmol/L、氯离子（100.50±3.50）mmol/L与治疗后（138.80±4.20）mmol/L、（102.80±3.00） mmol/L相比较,差异并不明显;心律波动情况在透析1h、2h、3h、4h各时间段数值没有显著变化.结论 无钾血液透析联合常规血液透析治疗透析前顽固性高钾患者疗效确切,治疗过程安全,不增加患者的经济负担,具有一定的临床应用价值。

Objectives To observe the potassium free blood dialysis with regular hemodialysis therapy before dialysis patients with refractory high potassium clinical curative effect.Methods Conservative treatment is invalid,potassium 〉 6.0 tendency before dialysis/L of 48 patients with maintenance hemodialysis,and approved by our hospital ethics committee and informed consent of patients to adopt potassium blood dialysis（2h） regular hemodialysis （2h） treatment,were observed before and after dialysis potassium changes.Results The combination therapy after 1 month before dialysis patients with potassium concentration by tendency for L （6.30 ＋ 1.10） （5.05 ＋ / -1.00） tendency to L,differences are more obvious;Combination therapy in the process of sodium ions （140.00 ＋ 3.80） tendencv,chloride ion （100.50 ＋ 3.50）/L tendency/L and （138.80 ＋ 4.20） after treatment tendency for L,（102.80 ～3.00） tendency for L,difference is not obvious;Rhythm of the volatility in the dialysis 1 h,2h,3h,4h each time value did not change significantly.Conclusions Potassium free blood dialysis with regular hemodialysis therapy before dialysis patients with refractory high potassium curative effect,safe treatment process,not to increase the economic burden of patients,it has certain clinical application value.