血液透析并发低血压反应的临床防治

Clinical prevention and treatment of hemodialysis associated with hypotension.

目的 总结血液透析中并发低血压反应的临床防治经验。方法 收集 1989～ 2 0 0 2年 12 2 85次血液透析中2 16 5次低血压反应的临床资料 ,比较醋酸盐透析与碳酸氢盐透析低血压反应的发生率 ,低温高钠透析与输注高渗葡萄糖治疗血液透析并发低血压反应的临床防治效果。结果 醋酸盐透析低血压反应的发生率明显高于碳酸氢盐透析 ,具有统计学意义。低温高钠透析与输注高渗葡萄糖比较 ,前者更能有效地预防低血压反应的发生 ,且有统计学意义。结论 应用碳酸氢盐透析。

Objective To sum up the experience of clinical prevention and treatment of hemodialysis associated with hypotension.Methods The clinical data of 2 165 cases of hypotension during 12 285 times of hemodialysis between 1989～2002 were collected. The occurrence of hypotension in the acetate dialysis and bicarbonate, and the effects of hypothermia high natrium dialysis and infusion of glucose of hyperosmolality in the treatment of hemodialysis associated with hypotension were compared. Results The occurrence of hypotension during acetate dialysis was significantly higher than during bicarbonate dialysis. Hypothermia high natrium dialysis could more effectively prevent the occurrence of hemodialysis associated with hypotension.Conclusion Bicarbonate dialysis and hypothermia high natrium dialysis are effective on preventing and curing the hemodialysis associated with hypotension.