渐增血流量治疗模式在透析低血压中应用效果.docVIP

渐增血流量治疗模式在透析低血压中应用效果 　　[摘要]目的 探讨渐增血流量治疗模式对透析低血压的防治效果。方法 选取2016年1～10月在我院行维持性血液透析（MHD）中频发透析低血压的患者19例，每次透析以100 ml/min的血流量引血，15 min后增加至120 ml/min，30 min后增加至160 ml/min，45 min后增加至180 ml/min，60 min后增加至200 ml/min，不再递增。该透析模式连续实施12周，每周3次，4 h/次。比较治疗前后透析低血压的发生率、透析后及透析中最低血压、透析时间、超滤量、血红蛋白、清蛋白及sp KT/V值的变化情况。结果 治疗后透析低血压的发生率较治疗前显著降低，差异有统计学意义（P0.05）。透析后血压、透析中最低血压、透析时间、超滤量、血红蛋白、清蛋白及sp KT/V值均显著升高，差异有统计学意义（P0.05）。结论 渐增血流量治疗模式可有效降低透析低血压的发生率，提高透析充分性，改善患者营养状况。 　　[关键词]维持性血液透析；透析低血压；透析血流量；透析充分性 　　[中图分类号] R692.5 [文献标识码] A [文章编号] 1674-4721（2018）4（c）-0054-04 　　The effect of slowly increasing blood flow rate treatment on intradialytic hypotension 　　ZHOU Yang YE Fan▲ YIN Jin-feng 　　Department of Nephrology，the Fourth Hospital Affiliated to Nanchang University，Jiangxi Province，Nanchang 330003，China 　　[Abstract]Objective To explore the therapeutic effect of slowly increasing blood flow rate treatment on intradialytic hypotension.Methods A total of 19 patients who have frequent intradialytic hypotension during the treatment of maintenance hemodialysis in our hospital from January to October 2016，were selected，who were treated with slowly increasing blood flow rate hemodialysis.Each time the patient′s blood was extracted at the blood flow rate of 100 ml/min，then increased to 120 ml/min after 15 minutes，30 minutes later increased to 160 ml/min，increased to 180 ml/min after 45 minutes，60 minutes later increased to 200 ml/min，no longer increases.The hemodialysis mode was performed continuously for 12 weeks，3 times a week for 4 hours.The incidence of intradialytic hypotension， after treatment blood pressure，the lowest blood pressure in hemodialysis，hemodialysis time，ultrafiltration，hemoglobin，albumin and spKT/V were compared.Results The incidence of intradialytic hypotension after treatment was much lower than before treatment，with a statistical difference （P0.05）.The after treatment blood pressure，the lowest blood pressure in hemodialysis，hemodialysis time，ultrafiltration，hemoglobin，albumin and