渐进式低温加可调钠透析法用于高危患者透析的效果观察

摘要

目的 观察渐进式低温加可调钠透析在防治高危患者透析低血压的有效性和安全性.方法 选择有低血压倾向的高危透析患者25 例,采用自身对照方法,随机分别进行10 次常温常规透析、低温可调钠透析、渐进式低温加可调钠透析,观察比较3 种方法血液透析过程中,血压值、超滤量和不良反应发生率及低血压发生率的差异.结果 透析中、透析后,3 组的收缩压、舒张压、超滤量比较差异有统计学意义(P＜0.001),低温可调钠法、渐进式低温可调钠法优于常温常规法;低温可调钠法、渐进式低温可调钠法透析低血压发生率明显低于常温常规法(P＜0.001);渐进式低温可调钠法患者的透析不良反应发生率,明显低于低温可调钠法和常温常规法(P＜0.001).结论 低温可调钠透析、渐进式低温可调钠透析可明显减少维持血液透析中高危患者的低血压发生率,但渐进式低温加可调钠透析更安全,适合有低血压倾向的高危透析患者,且温度可安全控制至35～34℃,明显减少透析不良反应发生率.%Objective To observe the effect and safety of progressive low temperature and sodium profile hemodialysis in the prevention of hemodialysis-related hypotension of high risk patients. Methods With self-control method, 25 high risk hemodialysis-related patients underwent 10 times of conventional dialysis of normal temperature, sodium profile hemodialysis of low temperature, progressive low temperature and sodium profile dialysis respectively. Blood pressure, ultrafiltration volume, adverse reaction rate and the incidence of hypotension during the dialysis were compared. Results The comparison of systolic and diastolic blood pressure and ultrafiltration volume during and after dialysis among three groups revealed statistic significance (P<0.001). There was much lower incidence of hemodialysis -related hypotension in sodium profile hemodialysis of low temperature group and progressive low temperature and sodium profile dialysis group than in conventional dialysis of normal temperature (P<0.001) and in progressive low temperature and sodium profile hemodialysis group, the adverse reaction rate reached the lowest (P<0.001). Conclusion Sodium profile hemodialysis of low temperature, progressive low temperature and sodium profile dialysis are effective for the prevention of hemodialysis-related hypotension while the later is safer, for with adjustable temperature, there is low incidence of adverse reaction mprofi le dialysis.