梯度压力弹力袜干预对透析低血压的预防作用

Effect of the intervention using graduated compression stocking on prevention of intradialytic hypotension

目的探索梯度压力弹力袜干预对血液透析患者透析低血压的预防效果。方法采用交叉配对设计,将18例维持性血液透析患者交叉分组到对照组(常规护理干预)和干预组(梯度压力弹力袜干预)进行干预,测量患者透析前即刻,透析1 h、2 h、3 h,下机前,下机后15 min的血压、心率,透析结束后患者的剩余超滤量和补液量。结果干预组发生透析低血压29例次,对照组为37例次。干预组透析1 h、2 h收缩压显著高于对照组,心率显著低于对照组(均P<0.05);透析后3 h、下机前和下机后15 min,两组血压比较,差异无统计学意义(均P>0.05);干预组剩余超滤量、补液量显著低于对照组(均P<0.05)。结论血液透析患者于透析时采用梯度压力弹力袜干预对透析低血压有一定的预防作用,能够减少透析剩余超滤量和透析中补液量,可保证血液透析治疗效果。

Objective To explore the effect of the intervention using graduated compression stocking on prevention of intradialytic hypotension for hemodialysis patients.Methods A cross matching design was utilized, and 18 maintennance hemodialysis patients were assigned to a control group(routine nursing intervention) and an intervention group(intervention using graduated compression stocking) crossover for intervention. The patients′ blood pressure and heart rates immediately before dialysis, 1 hour, 2 hours and 3 hours after dialysis, at the end of dialysis and 15 minutes stopping dialysis were measured, and their amount of residual ultrafiltration and fluid replenishment after dialysis were also measured.Results The intervention group suffered 29 case times intradialytic hypotension, and the control group encountered 37 case times. The systolic blood pressure at 1 and 2 hours after dialysis of the intervention group were significantly higher than those of the control group, their heart rates were significantly lower than those of the control group(P<0.05 for all);there were no significant differences in blood pressure between the two groups at 3 hours after dialysis, at the end of dialysis and 15 minutes stopping dialysis(P>0.05 for all);and the amount of residual ultrafiltration and fluid replenishment of the intervention group were significantly less than those of the control group(P<0.05 for both).Conclusion The intervention using graduated compression stocking during dialysis for hemodialysis patients could prevent intradialytic hypotension to some extent, reduce the amount of residual ultrafiltration and fluid replenishment during dialysis, and guarantee the treatment effect of hemodialysis.