【摘要】目的 观察血液透析泵控血流量(Qb)对患者动静脉内瘘血流量(Qa)的影响。方法 选择北京大学人民医院血液净化中心使用前臂标准内瘘的稳定血液透析患者21例，正确进行内瘘穿刺及连接HD02超声稀释血液透析监测仪。在透析开始后30min及结束前30min，分别将泵控血流量调至200、250、300ml/min，调整时间间隔为4min，在每一泵控血流量稳定2min后检测内瘘血流量, 并观察心率、血压。 结果 在上述不同的Qb下，透析开始30min后Qa分别为：(1123.0±457.9)ml/min、(1093.9±449.8)ml/min、(1153.9±436.3)ml/min(各组间P＞0.05)；透析结束前30minQa分别为：(1083.9±420.9)ml/min、(1042.3±413.8)ml/min、(1039.2±392.7)ml/min(各组间P＞0.05)；患者心率与血压无明显变化。结论 在透析开始及结束前，在泵控血流量200～300ml/min的范围内，内瘘血流量无显著变化，血压与心率稳定，间接反映了心功能的稳定性。

【Abstract】 Objective To study the impact of pump controlled blood flow (Qb) on blood flow in arteriovenous fistula (Qa) during hemodialysis. Methods A total of 21 maintenance hemodialysis patients with arteriovenous fistula were observed. After access to the fistula by successful puncture, the HD02 ultrasound hemodialysis monitor was connected to it. Thirty minutes after the beginning and 30 minutes before the end of a hemodialysis session, the Qb was sequentially adjusted to 200, 250 and 300ml/min in 4 minutes apart. When blood flow was stable for 2 minutes after every change of Qb, Qa was measured by HD02 hemodialysis monitor. Patients’ heart rate and blood pressure were recorded. Results Under the Qb of 200, 250 and 300ml/min, the Qa at 30 minutes after the beginning of the hemodialysis session were 1123.0±457.9, 1093.9±449.8 and 1153.9±436.3ml/min (P＞0.05), respectively, and the Qa at 30 minutes before end of the hemodialysis session were 1083.9±420.9, 1042.3±413.8 and 1039.2±392.7ml/min (P＞0.05), respectively. Patients’ heart rate and blood pressure remained unchanged. Conclusion At the beginning and the end of hemodialysis sessions, Qb in the range of 200～300ml/min did not affect the Qa significantly. Patients’ heart rate and blood pressure were stable. These results also demonstrate the stable cardiac function during hemodialysis sessions.