维持性血透患者频发透析相关心律失常原因及防治方法.docVIP

维持性血透患者频发透析相关心律失常原因及防治方法[摘要] 目的 探讨维持性血液透析患者在透析期间频发心律失常的原因及防治方法。方法 选择131例维持性血透患者，观察3个月，回顾性分析血透过程中频发心律失常（≥6次/3个月）患者的发生情况及其原因，并予以相应处理。结果 45例患者频发心律失常，共血液透析1551例次，发生心律失常323例次，发生率20.83%，心律失常类型以室性期前收缩、房性期前收缩、窦性心动过速和心房颤动为多。发现伴有年龄偏大、透析后低血钾、贫血、心肌缺血等因素的透析相关心律失常的发生率更高。结论 透析相关心律失常频繁发生与患者年龄偏大、合并贫血、心肌缺血、透析后低血钾等多种因素有关，积极纠正诱发透析相关心律失常的危险因素，可避免或减少透析相关心律失常的频繁发生。 [关键词] 血液透析；心律失常；终末期肾病 [中图分类号] R541.7 [文献标识码] B [文章编号] 1673-9701（2011）31-19-02 Cause and Prevention of Cardiac Arrhythmias Occurred Frequently in Patients with Maintenance Hemodialysis DAI Zaiyou YAN Haihong CHEN Xia CHEN Xiaoli WANG Kangyao CHENG Yongjun LI Yunsheng Department of Nephrology，the First Peoples Hospital of Wenling City，Zhejiang Province，Wenling 317500，China [Abstract] Objective To investigate the cause and methods of prevention and treatment of cardiac arrhythmias occurred frequently in patients with maintenance hemodialysis（HD）. Methods The data of 131 HD patients during the dialysis in three months were analyzed retrospectively on frequent cardiac arrhythmogenesis（≥6 times per 3 months）and its causes. Results The incidence of frequent cardiac arrhythmias in the dialysis patients was 20.83%. The premature ventricular，atria premature beats，sinus tachycardia and atrial fibrillation were common in the arrhythmias events. The risk of arrhythmias correlated with the patients age，hypokalemic of post-dialysis，anemia and myocardial ischemia. Conclusion The causes of arrhythmia in the HD patients were various. The arrhythmias during dialysis might be preventive and treatable if the risk factors were positively reduced. [Key words] Hemodialysis；Cardiac arrhythmia；End-stage renal disease 心律失常是维持性血液透析患者常见的并发症之一，其发生率可高达50%，也是血液透析患者死亡的重要原因之一。血液透析过程中透析相关心律失常的发生率较平时显著增加，其发病机制复杂，预后很差[1]。为了进一步探讨血液透析中心律失常频繁发生的可能原因及防治方法，以提高透析存活率，现对我院血液透析中心维持性血透患者进行观察，报道如下。 1 资料与方法 1.1 一般资料 选择我院血液透析中心2010年11月～2011年6月维持性血液透析患者131例，所有患者入选时已至少血透1个月以上、病情稳定，且已建立并开始使用长期通路，观察3个月，按心律失常发生频率，分为频发组（≥6次/3个月）与非频发组（＜6次/3个月），回顾性分