尿毒症血液透析期间患者的心电图变化探讨

Electrocardiogram changes in patients with uremia during hemodialysis

目的研究尿毒症患者在进行血透治疗期间心电图具体变化,以及心电图出现变化的原因。方法选取2018年1月至2019年5月于本院进行血液透析的尿毒症患者80例作为研究对象。在进行血液透析治疗前后为所有患者分别进行心电图检查,研究分析患者的心电图变化情况和影响因素。结果通过对120例次血透治疗进行分析,发现有106例次血透后心电图出现异常,显著高于血透前的发生率;血透后,患者出现心跳加速、ST-T改变和AT期间延长的概率高于血透治疗前,差异有统计学意义(P<0.05);血液透析后出现心电图异常状况的106例次中,有70.6%的患者年龄超过60岁,有68.9%的患者过滤量≥3 kg;74.5%的患者出现了血钾水平异常。结论进行血液透析有一定几率会对尿毒症患者的心脏功能产生负面影响,透析进行后更容易出现心电图异常情况。影响患者心电图出现变化的主要原因是患者的年龄、血钾含量以及血透超滤量等因素。

Objective To study the specific changes of electrocardiogram(ECG)in uremic patients during hemodialysis treatment and the causes leading to the changes of ECG.Methods A total of 80 uremic patients who underwent hemodialysis from January 2018 to May 2019 were selected as the subjects of this study.Before and after hemodialysis,all patients were examined by electrocardiogram to study and analyze the changes of electrocardiogram and the influencing factors.Results Through the analysis of 120 times of hemodialysis treatment,106 cases of abnormal ECG occurred after hemodialysis,which was significantly higher than that before hemodialysis.After hemodialysis,the probability of heart rate acceleration,ST-T change and prolongation during AT period was higher than that before hemodialysis treatment,and the difference was statistically significant(P<0.05).Among 106 cases with abnormal ECG after dialysis,70.6%of the patients were over 60 years old,68.9%of the patients had filtered more than 3 kg,and 74.5%of the patients had abnormal blood potassium level.Conclusion Hemodialysis has a certain probability of negative impact on the cardiac function of uremic patients,and ECG abnormalities are more likely to occur after hemodialysis.The main factors affecting the changes of ECG were age,blood potassium content and hemodialysis ultrafiltration volume.