中国血液净化 ›› 2020, Vol. 19 ›› Issue (03): 179-182.doi: 10.3969/j.issn.1671-4091.2020.03.009

• 临床研究 • 上一篇    下一篇

氧疗联合低温血液透析对透析性低血压的影响

张静1,金领微1,刘海萍1,胡旦翔1,黄佩佩1   

  1. 1温州医科大学附属第二医院育英儿童医院血液透析室
  • 收稿日期:2019-09-10 修回日期:2020-01-19 出版日期:2020-03-12 发布日期:2020-03-12
  • 通讯作者: 金领微 uyhagu3@yeah.net E-mail:uyhagu3@yeah.net
  • 基金资助:
    温州市科学技术局(Y20170494)

Effect of oxygen therapy combined with hypothermic hemodialysis on Intradialytic hypotension

  • Received:2019-09-10 Revised:2020-01-19 Online:2020-03-12 Published:2020-03-12

摘要:

【摘要】目的探讨氧疗联合低温血液透析(hemodialysis,HD)对透析性低血压(intradialytic hypotension, IDH)的影响。方法选取84 例HD 患者,采用前后自身对照法分为2 个阶段,I 阶段行单纯低温血液透析,II 阶段氧疗联合低温血液透析,均持续8 周。2 个阶段均分别监测透析过程中发生低血压的频率,并检测2 阶段的生化和血气参数。结果氧疗联合低温血液透析明显降低了IDH 的发作次数(从3.16±2.57 到1.98±1.84,t=4.030,P =0.001)。血清白蛋白在2 阶段存在微小差异,差异有统计学意义(I、II 阶段分别为(33.2± 2.9)和(32.3±2.5)g/L,t=2.154,P =0.033)。血气分析结果显示,与无氧疗阶段相比,氧疗显著降低了总二氧化碳(t=8.765,P<0.001)和碳酸氢根(t=10.820,P<0.001),提高了pH值(t=18.330,P<0.001)。结论氧疗联合低温血液透析对IDH 有更好的疗效,且能在一定程度上维持HD 中的代谢酸碱平衡。

关键词: 血液透析, 透析性低血压, 氧疗

Abstract:

【Abstract】Objective To investigate the effect of oxygen therapy combined with Hemodialysis (HD) on dialysis hypotension (IDH). Methods Eighty-four hemodialysis patients were selected and divided into two stages by self-control method. Stage I was treated with simple hypothermic hemodialysis, stage II oxygen therapy combined with hypothermic hemodialysis for 8 weeks. Two phases monitor the frequency of hypotension during dialysis and detect two-stage biochemical and blood gas analysis parameters. Results Oxygen therapy combined with hypothermic hemodialysis significantly reduced the number of episodes of IDH (from 3.16±2.57 to 1.98±1.84, t=4.030, P=0.001). There was a small difference in serum albumin between the two stages but it was statistically significant [stages I and II were (33.2±2.9) and (32.3±2.5)g/L, t=2.154, P=0.033]. The blood gas analysis showed that compared with the no oxygen therapy stage, Oxygen therapy significantly reduced TCO2 (t =8.765, P<0.001) and HCO3- (t=10.820, P<0.001) and increased pH (t=18.330, P<0.001). Conclusion Oxygen therapy combined with hypothermic hemodialysis has a better effect on IDH and can maintain the metabolic acid-base balance in hemodialysis to a certain extent.

Key words: Hemodialysis, Intradialytic hypotension, Oxygen therapy

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