钠及超滤曲线模式透析对血透中并发症的影响

目的 研究透析过程中运用钠及超滤曲线模式对血透患者在血液透析中可能发生的急性并发症的影响。观察其能否减少透析中低血压、肌肉痉挛、头痛、恶心、呕吐及透析中后高血压的发生率。方法 选择46例常规血液透析患者先采用常规血液透析模式(CHD)，后采用钠及超滤曲线呈阶梯下降模式(PHD)，观测患者血透中血压、脉搏、电解质、毒素的改变，记录并发症的发生率。结果 CHD低血压发生率16．30％，肌肉痉挛的发生率14．13％；PHD低血压发生率4．34％，肌肉痉挛的发生率3．98％，CHD中后高血压者在PHD后超滤量增加。干体重下降，高血压发生率降低39．97％。结论 PHD可以降低血液透析中低血压及肌肉痉挛的发生率，增加超滤量、降低干体重，对减少透中透后高血压的发生十分有益，对电解质酸碱平衡及毒素的影响与CHD无差异。

Effect of profile hemodialysis on decreasing acute complications of the patients receiving hemodialysis

Objective: To study the effect on the patients receiving hemodialysis of sodium profile combined with ultrafiltration profile(PHD). To examine whether PHD could decrease the incidence of hypotension, muscle cramps during dialysis and hypertention during and after dialysis. Methods: 46 patients receiving regular hemodialysis were chosen. Each patient received conventional hemodialysis (CHD) first and then received sodium and UF stepwise profile hemodialysis. Their blood pressure, pulse, electrolyte and acid-base toxin were monitored and complications incidence was recorded. Results: According to CHD the incidence of hypotension is 16.30%, the incidence of cramps is 14.13%, to PHD the hypotensim incidence is 4.34%, the cramp incidence is 3.98%, the hypertension incidence during and after CHD treatment is decreased 39.97% and estimated dry weight (EDW) is also decreased after PHD treatment. Conclusions: PHD can decrease the incidence of the complications such as hypotension and muscle cramps during dialysis and increase the tolerance of ultrafiltration, decrease the estimated dry weight and can help decrease the incidence of the hypertension occurred during and after dialysis. There is no difference in the electrolyte, acid-base balance and toxin between PHD and CHD.