应用生物电阻抗分析法指导透析超滤对残余肾功能的保护作用

发布时间：2018-03-28 09:43

本文选题：生物电阻抗　切入点：残余肾功能　出处：《安徽医科大学》2017年硕士论文

【摘要】：目的:观察应用生物电阻抗分析法指导新进入血液透析患者透析超滤对患者残余肾功能的保护作用。方法:选取2014年10月至2016年11月安徽医科大学174临床学院新进入血液透析的120例终末期肾病患者为研究对象,随机分为试验组及对照组,随访3个月。试验组应用生物电阻抗分析法指导透析超滤,对照组依据有无水肿、血压、透析过程中有无低血压症状及透析间期体重增加量来确定透析超滤量。比较两组前后的残余肾功能、24小时尿量、透析不良事件发生率。结果:两组残余肾功能、24小时尿量、收缩压、舒张压、白蛋白、血红蛋白、钙、磷及PTH水平的基线值差异无统计学意义。试验组残余肾功能及24小时尿量明显高于对照组。试验组血钙高于对照组。两组患者的收缩压、舒张压、随访期间透析不良事件发生率、白蛋白、血红蛋白、磷及甲状旁腺激素水平的差异无统计学意义。两组的残余肾功能及24小时尿量均较基线值下降(P0.05)。两组血红蛋白、白蛋白水平均较基线值升高。两组收缩压、舒张压均较基线值降低。两组血钙水平均较基线值升高,血磷较基线值升高,甲状旁腺激素较基线值升高。24小时尿量与残余肾功能水平相关。透析超滤量与残余肾功能的下降速度成正相关。透析超滤量与24小时尿量的下降速度成正相关。结论:应用生物电阻抗分析法指导血液透析超滤,能更准确的评估患者容量情况,有助于延缓残余肾功能的下降。
[Abstract]:Objective: to observe the protective effect of ultrafiltration on residual renal function of newly entered hemodialysis patients by bioelectric impedance analysis. Methods: from October 2014 to November 2016, 174 new clinic of Anhui Medical University was selected. 120 patients with end-stage nephropathy who entered hemodialysis were studied. The experimental group was followed up for 3 months. Bioelectrical impedance analysis was used to guide dialysis ultrafiltration, while the control group was based on edema and blood pressure. Whether there were hypotensive symptoms and weight gain during dialysis to determine the ultrafiltration volume. The 24 hour urine volume and the incidence of adverse events of dialysis were compared between the two groups. Results: the residual renal function in the two groups was 24 hours urine volume. Systolic blood pressure, diastolic blood pressure, albumin, hemoglobin, calcium, There was no significant difference in baseline values of phosphorus and PTH levels. The residual renal function and 24-hour urine volume in the trial group were significantly higher than those in the control group. The blood calcium level in the trial group was higher than that in the control group. The systolic blood pressure and diastolic blood pressure in the two groups were significantly higher than those in the control group. There was no significant difference in the incidence of adverse events, albumin, hemoglobin, phosphorus and parathyroid hormone levels during the follow-up period. The residual renal function and 24-hour urine volume in the two groups were significantly lower than the baseline values (P 0.05). The levels of albumin were higher than baseline values, systolic blood pressure and diastolic blood pressure were lower than baseline values, serum calcium levels and serum phosphorus levels in both groups were higher than baseline values, and serum phosphorus levels were higher than baseline values in both groups. The increase of parathyroid hormone compared with baseline value. 24 hours urine volume was correlated with residual renal function level, dialysis ultrafiltration volume was positively correlated with the rate of residual renal function decline, and dialysis ultrafiltration volume was positively correlated with 24 hour urine volume decline rate. Conclusion: bioelectric impedance analysis is used to guide hemodialysis ultrafiltration. A more accurate assessment of the patient's volume may help to delay the decline in residual renal function.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692.5

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