中国血液净化

›› 2002, Vol. 1 ›› Issue (8): 21-23.

• 论著 • 上一篇    下一篇

可调钠血液透析对透析低血压的预防作用

刘 虹 刘伏友 彭佑铭 朱健玲 李 军 陈 星   

  1. 410011 长沙，中南大学湘雅二医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2002-08-19 发布日期:2002-08-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2002-08-19 Published:2002-08-19

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摘要： 【摘要】目的 透析低血压是血液透析患者的重要并发症，观察可调钠血液透析对透析低血压的作用，以及其对透析中血钠水平的影响。方法 2001年7月至2002年3月期间在我院血液净化中心行维持性血液透析的患者12例，其中男7例，女5例，年龄22～65岁(43.46±21.58)，透析前血BUN(20.86±4.53)mmol/L，血肌酐(1050.56±253.27)μmol/L，6人4周透析按普通钠、可调钠、普通钠、可调钠各一周方式进行，另外6人按可调钠、普通钠、可调钠、普通钠方式进行，每人每周透析两次，可调钠透析方式按东丽透析机面板上的6个钠档次进行，每50分钟下调一档，根据我中心检测，透析液钠浓度从开始的151mmol/L，至透析结束前半小时降为136mmol/L，普通钠透析组钠浓度为139mmol/L，在透析过程中观察透析低血压的症状及其频数，测定透析前透析后血钠的浓度。结果 透析低血压主要表现为血压明显下降、大汗淋漓、头痛、恶心、呕吐、心率减慢、严重者出现意识障碍、抽搐等，可调钠透析组，其透析低血压的发生较对照组明显减少（P<0.05），低血压的症状和体症的数量明显减少（P<0.05），透析前血压与透析中最低血压差可调钠组明显低于对照组。但透析前、透析后血钠浓度可调钠组、普通组无明显改变（P>0.05）。结论 可调钠透析可有效预防血液透析低血压的发生，而并不增加患者的钠负荷。

Abstract:

【Abstract】Objective To observe the preventing effect of modeling sodium on dialysis hypotension in hemodialysis. Methods 6 patients of 12 studied accepted hemodialysis according to the order as common sodium, modeling sodium, common sodium, modeling sodium for 1 week respectively and the other 6 patients accepted hemodialysis as modeling sodium, common sodium, modeling sodium, common sodium for 1 week respectively. The episodes and symptoms and signs of dialysis hyptension have been observed and blood sodium concentration has been examined before dialysis and after dialysis. Results The main symptom and signs of dialysis hypotension were the significant decrease of blood pressure, headache, nausea, vomiting, sweat and decrease of heart beat, even conscious disturbance and tic. Modeling sodium hemodialysis could decrease the episodes of hypotension and the occurrence of these symptoms (P<0.05). The blood sodium concentration after hemodialysis was not significantly changed compared with before hemodialysis (P>0.05). Conclusion modeling sodium hemodialysis can prevent the occurrence of dialysis hypotension effectively and do not increase the natrium load of the patients.

Key words: Hemodialysis, Dialysis hypotension