不同透析法与血液透析低氧血症的研究

对１０例维持性血液透析（血透）患者分别进行醋酸盐透析（ＡｃＨＤ）和碳酸氢盐透析（ＢｉＨＤ），观察不同透析时间ＡｃＨＤ组与ＢｉＨＤ组动脉血氧分压（ＰａＯ２）、白细胞（ＷＢＣ）和血红蛋白（Ｈｂ）的变化，旨在对血透低氧血症（ＨＸＡ）的发病机制进行探讨。结果：两组患者透析开始０时ＰａＯ２已偏低；随透析时间延长，ＰａＯ２处于低水平状态，且与ＷＢＣ和Ｈｂ之间无明显相关。提示：血透ＨＸＡ不仅在透析过程中发生，而且在透析前即已存在，其原因可能与慢性血透尿毒症患者Ｈｂ减少引起贫血性缺氧有关

Effects of different methods of hemodialysis on hypoxemia

To study the mechanism of hemodialysis (HD) with hypoxemia (HXA),acetate and bicarbonate were used in the maintaining HD in 10 patients respectively.The changes of arterial partial pressure of oxygen (PaO 2),white blood cell (WBC) count and hemoglobin (Hb) content were dctermined at different time of HD to observe the differences between the acetate group and the bicarbonate group.The result showed that PaO 2 in the two groups was slightly reduced at 0 hour of HD and was kept at a low level with the continuance of HD,and that PaO 2 level was not found to have a significant correlation with WBC and Hb.It is suggested that HXA occurs not only in the process of HD but already appears before HD.The decrease of PaO 2 in uremic patients with chronic HD may be relateded to the endogenous hypoxia due to Hb reduction.