参麦注射剂联合50%葡萄糖注射剂预防血液透析相关性低血压的疗效

Efficacy of Shenmai injection and hypertonic sugar liquid in prevention of hemodialysis-associated hypotension

目的观察参麦注射剂联合50%葡萄糖注射剂用于预防维持性血液透析患者发生低血压的疗效。方法 46例在维持血液透析中发生低血压的患者(6个月血透中发生低血压反应比例>50%),随机分成2组,各23例。对照组在血液透析时给予50%葡萄糖注射剂100 m L持续静脉滴注;观察组在给予50%葡萄糖注射剂100 m L的基础上,在每次透析开始时给予参麦注射剂50 m L缓慢静脉滴注。记录观察组和对照组在维持性血液透析3个月内发生低血压的次数以及透析前、透析2 h及透析后的收缩压及心率。结果观察组血液透析相关性低血压发生率(14.7%)明显低于对照组(34.9%);观察组透析2h、透析后的收缩压、平均动脉压均高于对照组(P<0.05)。2组透析前、透析2 h及透析后的心率之间差异未见统计学意义(P>0.05)。观察组在预防血透相关性低血压的总有效率(87.0%)明显高于对照组(60.9%),差异具有统计学意义(P<0.05)。结论参麦注射剂联合50%葡萄糖注射剂能有效预防血透相关性低血压,从而保证了透析的充分性,提高了透析的质量。

AIM To observe the effect of Shenmai injection and hypertonic glucose liquid on prevention of hemodialysis-related hypotension in patients with maintenance hemodialysis. METHODS The 46 patients（incidence rate of hypotension reaction within 6 months after hemodialysis was more than 50% ）with hemodialysis-related hypotension were randomly divided into 2 groups, 23 in control group and 23 in observation group. Patients in control group were treated with normal hemodialysis and 50% glucose liquid 100 mL, while observation group were treated with the 50% glucose liquid 100 mL combined with Shengmai injection 50 mL during hemodialysis. The frequencies of hypotension within 3 months after hemodialysis and blood pressure and heart rate pre-hemodialysis, 2 h after hemodialysis and posthemodialysis were observed. RESULTS The incidence rate of hemodialysis-associated hypotension in observation group （14.7 % ） was decreased markedly compared with control group（34.9 % ） . The 2 h after hemodialysis, post-hemodialysis systolic blood pressure and mean arterial pressure in observation group was higher than control group with significant difference （ P 〈 0.05 ）. No significant difference in heart rate at pre-hemodialysis, 2 h after hemodialysis and posthemodialysis was found between control group and observation group （ P 〉 0.05）. The effective rate of prevention in the observation group（87.0% ） was higher than control group（60.9% ） with significant difference（ P 〈 0.05 ）. CONCLUSION Shenmai injection and 50% glucose liquid could prevent the hemodialysis-related hypotension occurring, ensure the dialysis adequacy and improve the dialysis quality.