夜间血液透析对维持性血液透析患者透析并发症和耐受性的影响

目的 比较夜间血液透析(NHD)和传统血液透析(CHD)患者透析并发症和耐受性的差异.方法 选取第二军医大学长征医院NHD和CHD患者各72例,收集两组患者的临床资料,记录透析后恢复时间,并对其透析时低血压及透析后疲乏、瘙痒、肌肉痉挛、头晕、头痛、食欲下降、恶心、呕吐、睡眠障碍等身体不适,以及担心死亡、担心设备故障、失去自由、失去工作等心理上的压力和生活状况共20项指标进行问卷调查.结果 与CHD组比较,NHD组患者透析后恢复时间短(P＜0.01),透析期间低血压以及透析后疲乏、瘙痒、头晕、头痛、食欲下降、恶心、呕吐等并发症减少(P＜0.05,P＜0.01),失去自由的人数减少(P＜0.01),但担心设备故障的人数增多(P＜0.01).结论 NHD比CHD的血液透析相关并发症少,更能有效提高维持性血液透析患者的耐受性.

Effect of nocturnal hemodialysis on dialysis complications and tolerability in maintenance hemodialysis patients

Objective To investigate the effect of nocturnal hemodialysis(NHD) on dialysis-related complications in maintenance hemodialysis patients. Methods 72 patients with nocturnal hemodialysis in Shanghai Changzheng Hospital were selected as experimental group in January 2017. The dialysis initiation time was 22:00-22:30 at night and the end time was 5:30 - 6:00 the next day.72 patients with conventional hemodialysis were selected as the control group at the same time. The dialysis start time was 07:30-08:00 and the end time was 11:30-12:00. The clinical data of the two groups were collected and a questionnaire was made to investigate the complications of dialysis and post dialysis fatigue, pruritus, muscle spasm, hypotension, dizziness, and recovery time after dialysis. Results (1) There was no significant difference in age, denger, dialysis vintage and primary disease between NHD group and CHD group. (2) Compared to CHD group, post-dialysis fatigue, hypotension, itching, dizziness, headache, loss of appetite and other complications in NHD group were significantly reduced. The recovery time after the dialysis was significantly shortened in NHD group than that in CHD group (NHD 3.38±4.31h vs. CHD 9.39±8.93h). The degree of personal freedom in patients with NHD increased, although the number of patients who worried about equipment failure also increased. Conclusion Compared to conventional hemodialysis, nocturnal hemodialysis has less dialysis related complications and effectively improve the tolerance of hemodialysis.