血液透析低血压的相关因素及预防对策

目的探讨血液透析相关性低血压发生的原因、机制和预防措施。方法62例血液透析患者,每小时测1次血压,必要时每15~30min测血压1次。对于症状性低血压立即给予高渗溶液(50%葡萄糖溶液或0.9%氯化钠溶液)100ml~200ml泵前输入,同时减慢流速及降低透析液温度。结果低血压的发生以透析后3~4h发生率高。给予高渗溶液,症状迅速缓解。同时调整透析液钠浓度、温度和血流速度效果佳。结论密切观察患者生命体征变化是及时发现低血压的关键。而快速给予高渗溶液,则能迅速纠正低血压,配合高钠、低温透析效果更佳。

Factors related to hemodialysis-associated hypotension and its solution.

Objective To investigate the causes, mechanism and precaution of hemodialysis-associated hypotension.Methods Blood pressure was measured every hour, or every 15 min-30min if necessary. When symptomatic hypotension occurred, 100-200ml hypertonic solution (50% glucose solution or normal saline) was infused quickly, and dialysate temperature and flow rate were reduced at the same time.Results Hypotension usually occurred in 3h-4h after the start of hemodialysis. Hypertonic solution can relieve symptom quickly. If dialysate sodium concentration and temperature as well as bloodstream speed were adjusted at the same time, the effect was better.Conclusion Close monitor of patients' vital sign is the key to the discovery of hypotension in time. Prompt infusion of hypertonic solution can correct hypotension. If dialysate sodium concentration is increased and temperature is reduced, the effect is better.