应用超声稀释法监测血液透析患者血容量、心输出量对低血压的预测价值

目的监测血液透析期间低血压患者的有效血容量、外周血管阻力和心输出量的变化，探讨低血压患者的血液动力学变化规律。方法采用超声稀释法对20例维持性血液透析中频繁出现复发性低血压的患者进行透析前后中心血容量（CBV）、心输出量（CO）、心脏指数（CI）、外周血管阻力（PVR）的对比分析；在出现低血压反应后分别给予强心药和高浓度葡萄糖干预治疗并在调整干体重后观察上述各项指标的变化（△变量=治疗后-治疗前）。结果血液透析中患者低血压与ACBV和ACO直接相关（P〈0．05），而APVR变化无显著性差异（P〉0．05）；强心剂和高浓度葡萄糖干预治疗后ACBV（0．04＋0．06vs．11±0．04．）和ACO（0．33±0．15vs．0．70±0．16）有显著性差异，P均〈0．05。调整干体重前后。透析3hACO有明显升高（-1．63±0．68vs．-0．91±0．34），P〈0．05。结论血液透析期间低血压与有效血容量、心输出量直接相关，与外周血管阻力、心肌储备功能关系不明显。超声稀释法可简便、非侵入性监测血液透析患者血液动力学改变．为干预性治疗提供依据．

The predictive value of ultrasound didution in monitoring hypotension in hemodialysis patients

Objective To abserve the effective circulating blood volume (CBV), peripheral vascular resistance (PVR)and cardiac output (CO)on dialysis patients with intradialytic hypotension, and to better understand the haemodynamics changes during dialysis in order to improve dialysis quality. Methods The changes of central blood volume,cardiac output,cardiac index (CI)and peripheral vascular resistance before and after haemodialysis were measured by HD02 Haemodialysis monitor during haemodialysis session. In additon ...