中国血液净化

›› 2004, Vol. 3 ›› Issue (9): 481-483.

• 论著 • 上一篇    下一篇

透析低血压与非透析低血压血容量状况的分析

翟林云 张小梅   

  1. 226006 南通，江苏省南通市第三人民医院肾脏内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2004-09-12 发布日期:2004-09-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2004-09-12 Published:2004-09-12

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摘要：

目的 分析血液透析和超滤过程中透析相关低血压的发生与血容量变化的关系。探讨症状性 透析低血压的防治策略。方法 以过去3月内发生过症状性透析低血压为观测组（23例），设无透析低血压的为对照组（28例）。应用超声血容量检测仪比较透析低血压者和正常对照者在透析超滤过程中血容量的变化特点、以及血压、心率的相应变化。结果 低血压组的透析间体重增加量、超滤量明显高于对照组（ P<0.02）。透析1小时后相对血容量、血压的下降程度超过对照组（P<0.05）；而反射性的心率增快方面，低血压组低于对照组（P<0.05）。结论 血容量下降是发生低血压的重要机制，尤其是透析者伴有心血管功能损害时，更易发生透析低血压。而提高血容量是治疗症状性透析低血压的关键措施。

关键词: 透析低血压, 血容量, 超声血容量监测仪

Abstract:

Objective To analyze the blood volume status of dialysis hypotension and non-dialysis hypotension in hemodialysis patients.
Methods Fifty-one patients with maintenance hemodialysis were divided into hypotension group (23 patients) and control group (28 patients) according to auompanied with or not symptomatic hypotension during dialysis in last three months. The blood volume, blood pressure and heart rate of hemodialysis patients were analyzed retrospectively. Results The interdialytic weight gain and ultrafiltration volume of hypotension group were significantly higher than control group (P<0.02). A comparison between intradialytic hypotesion group and none hypotension group showed significant difference in blood volume less, blood pressure decrease and heart rate increase during hemodialysis (P<0.05). Conclusion The immediate cause of intradialytic hypotension is intravascular hypovolemia related to the dialysis procedure. Particularly in patients with a compromised cardiovascular system, the risk of hypotension is high. We conclude that administration of fluid is an effective method in maintaining BP and in presering BV in hypotension-prone dialysis patients.

Key words: Blood volume, Blood volume monitor

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