透析低血压与非透析低血压血容量状况的分析

目的分析血液透析和超滤过程中透析相关低血压的发生与血容量变化的关系.探讨症状性透析低血压的防治策略.方法以过去3月内发生过症状性透析低血压为观测组(23例),设无透析低血压的为对照组(28例).应用超声血容量检测仪比较透析低血压者和正常对照者在透析超滤过程中血容量的变化特点、以及血压、心率的相应变化.结果低血压组的透析间体重增加量、超滤量明显高于对照组(P＜0.02).透析1小时后相对血容量、血压的下降程度超过对照组(P＜0.05);而反射性的心率增快方面,低血压组低于对照组(P＜0.05).结论血容量下降是发生低血压的重要机制,尤其是透析者伴有心血管功能损害时,更易发生透析低血压.而提高血容量是治疗症状性透析低血压的关键措施.

The analysis of blood volume status of dialysis hypotension and non- dialysis hypotension

Objective To analyze the blood volume status of dialysis hypotension and non-dialysis hypotension in hemodialysis patients. Methods Fifty-one patients with maintenance hemodialysis were divided into hypotension group (23 patients) and control group (28 patients) according to auompanied with or not symptomatic hypotension during dialysis in last three months. The blood volume, blood pressure and heart rate of hemodialysis patients were analyzed retrospectively.Results The interdialytic weight gain and ultrafiltration volume of hypotension group were significantly higher than control group (P<0.02). A comparison between intradialytic hypotesion group and none hypotension group showed significant difference in blood volume less, blood pressure decrease and heart rate increase during hemodialysis (P<0.05).Conclusion The immediate cause of intradialytic hypotension is intravascular hypovolemia related to the dialysis procedure. Particularly in patients with a compromised cardiovascular system, the risk of hypotension is high. We conclude that administration of fluid is an effective method in maintaining BP and in presering BV in hypotension-prone dialysis patients.