血液透析中低血压的原因及防治

目的通过观察血液透析中血压的变化,探讨低血压发生的原因及防治措施。方法选择28例维持性血液透析患者进行2960次血液透析,共发生低血压246次,探讨其与透析方法、时间及药物等的关系。结果低血压以透析3h后发生率最高,超滤过多过快,引起有效循环血量不足是最常见的原因,另外高龄、营养不良、大量进食、降压药物等也可导致低血压。结论避免过多过快超滤、准确评估干体质量、调整透析方法、合理用药等可减少透析过程中低血压的发生率。

Hypotension During Hemodialysis Causes and Prevention

Objective To observe the changes in blood pressure during hemodialysis and to explore the causes and prevention of hypotension.Methods Twenty-eight patients on hemodialysis of 2960 courses were enrolled.Hypotension occurred in 246 patients and its relationship with dialysis,time and medication was analyzed.Results At 3 h following the dialysis,hypotension was at the peak rate,mainly due to the excessive and rapid ultrafiltration causing the compromise of effective circulating volume in addition to ageing,malnutrition,overeating,and antihypertensives.Conclusion The occurrence of hypotension could be minimized by avoiding the excessive and rapid ultrafiltration,accurately estimating the lean body mass,appropriately adjusting the dialysis regimen and medication.