序贯钠透析在预防透析低血压中的应用

Application of Sequential Sodium Dialysis in Preventing Intradialytic Hypotension

目的 :研究序贯钠透析对透析低血压的预防作用。方法 :对连续 4次血透中发生透析低血压≥ 2次的 16例应用序贯钠透析干预共 92次 ,观察血液透析中的血压变化和临床症状的改善情况 ,干预前次透析液钠浓度均为 14 0mmol/L ,序贯钠透析起始钠浓度为 15 0mmol/L ,逐渐降至 138mmol/L。结果 :应用序贯钠透析后 ,透析中最低血压、透析后和透析中的平均收缩压的升高显著 ,大于 10mmHg(P <0 .0 1) ,临床症状几乎完全消失 ,未发现患者有任何不耐受情况。结论 :应用序贯钠透析能够非常有效地预防透析低血压的发生 。

Objective: To study the efficacy of sequential sodium dialysis in preventing intradialytic hypotension. Methods: 16 patients who experienced hypotention over 2 times during 4 sequential hemodialysis were studied. The sequential sodium dialysis were applied for 92 times, and the fluctuation of blood pressure (BP) and the improvement of clinical symptoms were observed. The concentration of dialysate sodium was 140 mmol/L before the intervention, and the concentration of sodium was 150 mmol/L at the start of sequential sodium dialysis, and then gradually reduced to 138 mmol/L . Results:The lowest BP during dialysis and the average systolic pressure during and after dialysis were significantly increased (more than 10mmHg, P < 0.01 ), the symptoms disappeared almost completely and patients tolerated the treatment well. Conclusion:The application of sequential sodium dialysis is effective and safe in preventing low BP induced by dialysis.