血容量监测防治高龄老年血液透析相关性低血压自身前后对照研究

目的通过在线血容量监测(BVM),了解高龄老年透析患者透析过程中的血容量、平均动脉压(MAP)、超滤量、超滤率的变化,分析相关指标的关系,防治低血压,调整透析患者干体质量、达到个体化理想容量、保证透析顺利进行、减少透析并发症。方法 28例规律性血液透析患者自身对照,平均透析时间(69±37)个月,统计同组患者3个月每周3次共672次透析过程中,进行BVM给予适时的治疗、护理干预与不进行BVM发生的低血压与低血压相关症状进行研究。结果透析过程中随超滤脱水量增加,超滤脱水率逐渐下降,超滤量最大,超滤率最高,相对血容量(RBV)的下降也最明显,同时伴MAP下降。在透析到3h左右,血压下降明显,RBV和血压呈显著正相关(r=0.392,P=0.020),和心率、血红蛋白、红细胞压积呈负相关。结论在线BVM有助于确定合适的超滤量,调整干体质量,从而达到个体化的容量和理想的血压,有效降低高龄老年透析患者在透析过程中低血压的发生,保证透析顺利进行,提高透析充分性,改善患者的生活质量,延长其生命。

The self-controlled study of preventing elderly hemodialysis-related hypotension by applying blood volume monitoring

Objective To understand the change of blood volume,average arterial pressure,ultra filter quantity and ultra filtering rate of elderly dialysis patients during dialysis process through the online blood volume monitor(BVM).By analyzing the relationship between the related index,preventing hypotension,and adjusting the dry weight of dialysis patients,achieve the individual ideal capacity,ensure the smooth process of dialysis and reduce dialysis complication.Methods Twenty-eight hemodialysis patients were self...