维持血液透析病人并发低血压的临床特征分析

目的分析维持血液透析并发低血压病人的临床特征。方法回顾性分析接受维持性血液透析的慢性肾衰病人127例临床资料，按照病人血液透析过程中有无低血压发生将病人分为发生组和未发生组，比较2组病人的相关临床指标，并分析血液透析病人低血压的影响因素。结果127例病人中发生低血压67例(52.75%)；127例病人共透析8 255例次，发生低血压1 125例次(13.63%)。发生组和未发生组病人体质量、左心室射血分数、血细胞压积、血红蛋白、血清白蛋白、血清总蛋白差异均无统计学意义(P>0.05)；2组年龄、超滤量和超滤量/体质量比值差异均有统计学意义(P < 0.05~P < 0.01)。Logistic回归分析显示，年龄、超滤量、超滤量/体质量比值均为影响血液透析病人低血压发生的独立危险因素(P < 0.01)。结论低血压是维持血液透析病人的常见并发症，年龄、超滤量、超滤量/体质量比值是血液透析发生低血压的独立危险因素，临床治疗时应密切观察老年病人和超滤量高的病人，及时做好预防措施。

Analysis of the clinical characteristics of maintenance hemodialysis patients complicated with hypotension

ObjectiveTo analyze the clinical features of maintenance hemodialysis patients complicated with hypotension.MethodsThe clinical data of 127 chronic renal failure patients treated with maintenance hemodialysis were retrospectively analyzed.According to the presence or absence of hypotension during hemo dialysis, the patients were divided into the occurrence group and non-occurrence group.The clinical indicators were compared between two groups, and the influencing factors of hypotension in hemodialysis patients were analyzed.ResultsAmong 127 patients, 67 cases(52.75%) with hypotension during hemo dialysis were found.A total of 8 255 times hemo dialysis in 127 patients were performed, and the hypotension occurred in 1 125 times(13.63%).The differences of the body mass index, left ventricular ejection fraction, hematocrit, hemoglobin, serum albumin and total serum protein between two groups were not statistically significant(P>0.05), and the differences of the age, ultrafiltration volume and ratio of ultrafiltration volume to body mass between two groups were statistically significant(P < 0.05 to P < 0.01).The results of logistic regression analysis showed that the age, ultrafiltration volume and ratio of ultrafiltration volume to body mass were the independent risk factors for hypotension in hemodialysis patients(P < 0.01).ConclusionsHypotension is a common complication of maintenance hemodialysis patients.The age, ultrafiltration volume, and ratio of ultrafiltration volume to body mass are the independent risk factors for hypotension in hemodialysis patients.In clinical treatment, the elderly patients and patients with high ultrafiltration volume should be closely observed, and the preventive measures should timely be taken.