终末期肾病维持性血液透析患者改良程序超滤模式超滤后低血压发生情况观察

发布时间：2018-11-18 10:10

【摘要】：目的观察终末期肾病维持性血液透析(血透)患者实施改良程序超滤模式超滤后低血压发生情况。方法将65例维持性血液透析患者随机分为A组22例、B组22例和C组21例。三组患者均连续行常规血液透析10次,总超滤量相等。A组采用改良程序超滤模式超滤,第1、2、3、4 h超滤量分别为总超滤量的32%、28%、24%、16%;B组采用传统程序超滤模式超滤,第1、2、3、4 h超滤量分别为总超滤量的40%、30%、20%、10%;C组患者采用恒速超滤模式超滤,第1、2、3、4 h超滤量分别为总超滤量的25%。测量并比较三组患者血透前和血透后的收缩压、舒张压并计算平均动脉压,统计三组透析后低血压发生情况。结果 A、B、C组患者血透前平均动脉压分别为(105.4±8.5)、(106.3±7.2)、(104.8±8.3)mm Hg,透析后平均动脉压分别为(99.2±6.3)、(97.3±5.5)、(94.6±5.8)mm Hg。三组患者血透后平均动脉压均低于血透前,P均0.05;且血透后平均动脉压A组B组C组,P均0.05。A、B、C组透析后低血压发生率分别为8.2%(18/220)、10.9%(24/220)、23.8%(50/210),透析后低血压发生率A组B组C组,P均0.05。结论终末期肾病维持性血透患者实施改良程序超滤模式超滤后低血压发生较少。
[Abstract]:Objective to observe the incidence of hypotension after ultrafiltration in patients with end-stage nephropathy maintenance hemodialysis (hemodialysis). Methods Sixty-five patients with maintenance hemodialysis were randomly divided into three groups: group A (n = 22), group B (n = 22) and group C (n = 21). The total ultrafiltration capacity was equal in group A. in group A, the ultrafiltration rate was 32% of the total ultrafiltration volume in 32% of the total ultrafiltration volume in the first 2 ~ 2 ~ 2 ~ 3 ~ (th) h, and the total ultrafiltration volume was 24 ~ 16% of the total ultrafiltration volume. In group B, the ultrafiltration capacity was 40% of the total ultrafiltration volume in the first 2 days and 3 minutes after 4 hours. In group C, the constant rate ultrafiltration mode was used in group C, and the ultrafiltration volume in group 1 was 25% of the total ultrafiltration volume in 3 hours. Systolic blood pressure, diastolic blood pressure and mean arterial pressure were measured and compared before and after hemodialysis. Results the mean arterial pressure before hemodialysis was (105.4 卤8.5), () 106.3 卤7.2), (104.8 卤8.3) mm Hg,) after dialysis in group C (99.2 卤6.3), (, 97.3 卤5.5), respectively. (94.6 卤5.8) mm Hg.) The mean arterial pressure after hemodialysis in the three groups was lower than that before hemodialysis (P < 0.05). The incidence of hypotension after hemodialysis was 8.2% (18 / 220), 10.9% (24 / 220), 23.8% (50 / 210) in group A and B, respectively. The incidence of hypotension after dialysis in group A, group B, group C, P Conclusion the hypotension after ultrafiltration in patients with end-stage renal maintenance hemodialysis is less.
【作者单位】：山东中医药大学;山东中医药大学附属医院;
【分类号】：R692.5

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