低温透析对血液透析过程中低血压的干预研究

目的探讨透析液温度与盐浓度对血液透析过程中低血压的干预策略及临床疗效。方法选择常规接受血液透析时间超过6个月,有超过3/4透析次数中发生症状性低血压,同时收缩压下降至少25%和(或)收缩压低于100 mm Hg,需要药物干预的门诊患者4例。每个患者分别接受低温透析、常温标准透析各3次,监测患者的平均动脉压(MAP),数据用Microsoft Excel登记汇总,用SSPS 13.0软件进行单样本t检验分析,以P<0.05为差异有统计学意义。结果两组病例透析中、透析后的MAP进行方差分析,各组在P<0.05水平上差异有统计学意义。结论低温透析改善患者对超滤的耐受性,有益于避免透析过程中低血压(IDH),显著减少了护理措施和医疗成本,患者对低温高盐透析感知正面积极,是一种简单、有益和经济的措施。

The effect of hypothermal dialysate on intradialytic hypotension occurrence

Objective To explore the strategies of using hypothermal dialysate to reduce the occurrence of intradialytic hypotension(IDH),and observe its clinical effects.Methods Four out-patients of our unit who have received haemodialysis for more than 6 months,who had shown symptomatic hypotension for three times in four dialyses and had a systolic blood pressure reduced by 25% and(or) lower than 100 mm Hg,so needing medication,were selected to participate this experiment.Each patient underwent low-temp and room-temp dialysis for 3 times respectively;mean arterial pressure(MAP) was monitored during the process.Microsoft Excel was used to enroll and collect the data,SSPS software was used to do one-sample test,and statistical significance was defined as P<0.05.Results One-sample test of the MAP data during and after haemodialysis in the 4 cases showed that there were significant differences at the level of P<0.05 in each group.Conclusion Hypothermal dialysis improves the tolerance to dialysis of hypotensive patients,and helps increase ultrafiltration while maintaining haemodynamic stability during and after dialysis.Patients′ perception is positive.The use of hypothermal dialysate is a simple,useful and economical procedure,especially for the highly symptomatic patients.