维持性血液透析患者透析相关性低血压的影响因素分析

Analysis of Influencing Factors of Dialysis-related Hypotension in Patients With Maintenance Hemodialysi

目的探讨维持性血液透析患者其透析相关性低血压的影响因素,以制定相关预防措施。方法选取我院2017年12月2018年12月维持性血液透析患者155例作为研究对象,根据透析过程中有无低血压分为低血压组(即L组,n=56)、非低血压组(即M组,n=99)。回顾性分析两组患者资料,探讨透析相关性低血压和患者年龄、透析龄、血红蛋白、超滤量、甲状旁腺激素、血钙、血磷之间的关系,透析相关性低血压和患者性别、病因的关系。P<0.05为差异有统计学意义。结果单因素分析结果显示低血压组和非低血压组在年龄、透析龄、血红蛋白、超滤量、甲状旁腺激素、血磷方面,组间差异有统计学意义;在性别、病因、血钙方面组间差异无统计学意义;多因素分析结果显示,高龄,透析龄长,血红蛋白低,透析超滤量过多,甲状腺激素明显升高,血磷高是发生低血压的危险因素。结论对于高龄,透析龄长,重度贫血,透析超滤量过多,甲状腺激素及血磷明显升高的血液透析患者,临床更应该加强透析过程中的监测,限盐、限水,纠正贫血,降低甲状旁腺激素及血磷。

Objective To explore the influencing factors of dialysis-related hypotension in patients with maintenance hemodialysis, so as to formulate relevant preventive measures. Methods A total of 155 patients with maintenance hemodialysis from December 2017 to December 2018 in our hospital were selected as the study subjects. According to whether there was hypotension during dialysis, patients were divided into hypotension group (group L, n =56) and non-hypotension group (group M, n =99). The data of patients in the two groups were retrospectively analyzed to explore the relationship between dialysis-related hypotension and patients' age, dialysis age, hemoglobin, ultrafiltration volume, parathyroid hormone, blood calcium and blood phosphorus, as well as the relationship between dialysis-related hypotension and patients' gender and etiology. P < 0.05 was considered statistically significant. Results There were statistically significant differences in age, dialysis age, hemoglobin, ultrafiltration volume, parathyroid hormone and blood phosphorus between the two groups. There were no statistically significant differences in gender, etiology and serum calcium between two groups. Multivariate analysis showed that the risk factors of hypotension were old age, long penetrating age, low hemoglobin, excessive dialysis ultrafiltration, marked increase of thyroid hormone, and hyperphosphatemia. Conclusion For the elderly, long penetration age, severe anemia, dialysis ultrafiltration quantity is too much, thyroid hormone and blood phosphorus significantly increased hemodialysis patients, clinical should strengthen the monitoring during dialysis, salt and water limit, correct anemia, reduce parathyroid hormone and blood phosphorus.