血液透析低血压的相关因素与预防研究

Related Factors and Prevention Research of Hemodialysis Hypotension

目的探讨血液透析低血压的相关因素及其预防方法与效果。方法便利抽取该院2015年1月—2018年1月血液透析患者160例作为研究对象,根据有无低血压分为观察组(低血压,n=70)、对照组(非低血压,n=90),回顾性分析两组临床资料,总结危险因素,制定预防措施。结果通过比较两组年龄、性别、病因、病程、合并症、透析龄、超滤量、超滤率、血红蛋白、血糖、PTH等因素,显示组间在年龄、透析龄、超滤量、超滤率、血红蛋白、血糖、PTH上比较差异有统计学意义(61.42±7.96)岁vs (55.34±7.25)岁,(4.77±1.02)年vs (3.01±0.49)年,(4.12±0.62)m L vs (2.91±0.74)mL,(1.28±0.35)L/h vs (0.82±0.23)L/h,(7.13±1.23)g/L vs (9.51±1.96)g/L,(9.22±1.95)mmol/L vs (6.28±2.01)mmol/L,(622.31±88.67)pg/mL vs (411.36±77.53)pg/mL (t=6.023、3.201、4.382、2.903、3.374、4.043、10.991,P<0.05);对存在差异的因素进行多因素分析,显示高血糖、高PTH、超滤率高属于高危因素(OR=2.19、2.01、3.06,P<0.05)。结论血液透析低血压比较常见,高血糖、高PTH、超滤率高属于低血压高危因素,需加强重视,尽早预防干预。

Objective To explore the related factors of hemodialysis hypotension and its prevention methods and effects. Methods A total of 160 patients with hemodialysis from January 2015 to January 2018 in the hospital were enrolled conve- niently. The patients were divided into observation group （hypotension, n=70） and control group （non-hypotension, n=90） ac- cording to the presence or absence of hypotension, retrospective analysis of two groups of clinical data, summary of risk fac- tors, development of preventive measures. Results By comparing the age, sex, etiology, course of disease, eomorbidity, dial- ysis age, ultrafiltration volume, ultrafiltration rate, hemoglobin, blood glucose, PTH and other factors, the age, dialysis age, ultrafiltration volume, super filtration rate, hemoglobin, blood glucose and PTH was significant （61.42±7.96）years old vs （55.34±7.25）years old, （4.77±1.02）years vs （3.01±0.49）years, （4.12±0.62）mL vs （2.91±0.74）mL, （1.28±0.35）L/h vs （0.82± 0.23）L/h, （7.13±1.23）g/L vs （9.51±1.96）g/L, （9.22±1.95）mmol/L vs （6.28±2.01）mmol/L, （622.31±88.67）pg/mL vs （411.36 ± 77.53）pg/mL （t=6.023, 3.201, 4.382, 2.903, 3.374, 4.043, 10.991, P〈0.05）; multivariate analysis of factors with differences showed high blood sugar, high PTH, high ultrafiltration rate of high risk factor （OR=2.19, 2.01, 3.06, P〈0.05）. Conclusion Hemodialysis hypotension is more common. Hyperglycemia, high PTH and high ultrafihration rate are high risk factors for hypotension. It is neeessary to strengthen the attention and prevent intervention as soon as possible.