三种不同透析模式在血液透析高危患者中对血压的影响及比较

目的观察比较常规、低温及低温可调钠三种透析模式在血液透析高危患者中对血压的影响。方法选择上海交通大学附属上海市第一人民医院松江分院肾内科血液透析患者20例,均为高龄、糖尿病肾病及心功能不全伴有终末期肾病患者,随机分别采用常温常规透析、低温常规透析、低温加可调钠透析三种透析模式,每例患者每种模式观察10次,比较透析时出现低血压及低血压症状出现的例次数。结果常温常规组（A组）,低温常规组（B组）和低温可调钠组（C组）出现低血压的发生率分别为20.5%,15.5%及7%,C组与A组比较,差异有显著性（P〈0.01）。结论低温可调钠透析可有效地降低血液透析高危患者透析中出现低血压的发生率,提高血液透析的耐受性。

Comparative study on blood pressure in high risk patients treated with three different kinds of hemodialysis

Objectives To compare the incidence of hypotension in high risk patients treated with room temperature, low temperature, and low temperature with sodium adjustable hemodialysis. Methods Twenty hemodialysis patients with high risk conditions, such as end-stage kidney diseases complicated with old age, diabetic nephrosis and heart failure, were randomly treated with conventional dialysis of normal temperature （group A）, conventional dialysis of low temperature （group B） or low temperature with sodium adjustable dialysis （group C）. Every patient was sequentially treated with the 3 kinds of dialysis, 10 times for each method. The incidence of hypotension and its symptoms during hemodialysis was compared. Results The incidence of blood hypotension was 20.5%, 15.5% and 7% in group A, B and C, respectively, and the incidence in group A and C is statistically different （P〈0.01）. Conclusion The method of low temperature with sodium adjustable hemodialysis is effective to prevent hypotension during hemodialysis, and thus improves the tolerance to hemodialysis in high risk patients.