序贯透析联合低温可调钠透析对透析相关性低血压的临床应用研究

目的 探讨序贯透析联合低温可调钠透析对透析相关性低血压的治疗作用.方法 21例透析相关性低血压患者采用前瞻性交叉设计方法,先后采取标准常温常规透析、低温可调钠透析、序贯透析、序贯透析联合低温可调钠透析等4种不同透析模式,每人每种透析模式实施3周.观察各组患者体质量改变、超滤量,透后血肌酐、尿素氮、血钾、血钠,透析中最低血压并计算平均动脉压(MAP),透析相关性低血压发作次数、发生时间和需要的护理干预措施.结果 序贯透析联合低温可调钠透析组低血压的发生率较常规透析组显著降低,较序贯透析组和低温可调钠透析组明显降低;4种透析模式对患者的溶质清除,调节透后血钾、血钠,均无统计学差异.结论 序贯透析联合低温可调钠透析能较好地预防透析相关性低血压的发生,不影响透析效果,操作简便易行.

The clinical study of sequential dialysis and low-temperature sodium-adjustable dialysis on intradialitic hypotension

Objectives To evaluate the value of sequential dialysis (SD) and low-temperature sodium-adjustable dialysis on intradialitic hypotension (IDH).Methods 21 patients with IDH were treated with standard room temperature conventional dialysis,low-temperature sodium-adjustable dialysis,SD,SD and low-temperature sodium-adjustable dialysis using prospective cross-over design method,each dialysis mode is implemented for 3 weeks.Changes of body mass,ultrafiltration volume,post dialysis serum creatinine,urea nitrogen,serum potassium,serum sodium,the most low blood pressure and mean arterial pressure (MAP) were calculated and observed in each group,and the number of IDH,the time of occurrence and the need of nursing intervention were observed.Results The incidence of hypotension in the SD and low-temperature sodium-adjustable dialysis group was significantly lower than that of the conventional dialysis group,compared with the SD group and the low-temperature sodium-adjustable dialysis group.There were no statistically different in 4 kinds of dialysis models on solute clearance,adjustment through after dialysis the serum potassium and erum sodium for patients.Conclusions The SD and low-temperature sodium-adjustable dialysis can prevent the occurrence of the IDH,which does not affect the result of dialysis,and the operation is simple.