低温可调钠曲线超滤透析防治血液透析相关性低血压的疗效观察

The efficacy of prevention and treatment of hemodialysis related hypotension with the lower temperature,adjustable sodium and curve ultrafiltration in dialysis

目的探讨低温可调钠曲线超滤透析防治血液透析相关性低血压的疗效。方法对于常温普通血液透析治疗8周过程中反复发生低血压的32例患者,采用自身对照法,改为低温可调钠曲线超滤透析8周。观察2种透析模式透前血压、透中最低血压、透后血压、透中低血压发生率及超滤量的变化。结果新的透析与普通透析比较:透前收缩压(SBP)及舒张压(DBP)均无明显变化(P>0.05);透中最低SBP及DBP均明显升高(P<0.05);透后SBP及DBP均显著升高(P<0.05);透中低血压发生率(7.26%vs 35.16%)明显降低(P<0.05),但超滤量显著增加(P<0.05)。结论这种新的透析模式可有效防治血液透析相关性低血压。

Objective To explore the efficacy of the lower temperature, adjustable sodium and curve ultrafihration hemodialysis for the prevention and treatment of hemodialysis related hypotension. Methods 32 patients with repeated hypotension during the treat- ment of general hemodialysis at the room temperature for 8 weeks. Then adopted another dialysis pattern that lower temperature, adjusta- ble sodium, curve ultrafihration accompanied with dialysate sodium concentration for 8 weeks as self - control. Observed the patients ＇ pre - dialysis blood pressure, the lowest blood pressure in the process of hemodialysis, post - dialysis blood pressure, the incidence of hypotension and the post -dialysis ultrafiltration volume during the two different hemodialysis patterns. Results There was no signifi- cant difference between two patterns in pre- dialysis systolic blood pressure （SBP） and diastolic blood pressure （DBP） （P 〉0.05 ）. The lowest SBP and DBP during hemodialysis was significantly higher in the new pattern than the general therapeutics （ P 〈 0.05 ）. The post - dialysis SBP and DBP in the new dialysis method was also significantly higher than the general ones （ P 〈 0.05 ）. The incidence of hypotension in new pattern （7.26%） was significantly lower than the general one （35.16%） （ P 〈 0.05 ）, on the contrary, the uhrafil- tration volume was obviously higher than the general one （P 〈 0.05）. Conclusion This study confirms that lower - temperature, ad- justable sodium with curve ultrafiltration hemodialysis can effectively prevent the occurrence of hypotension in patients with hemodialysis.