老年血液透析患者低血压的原因分析及护理应对措施.docxVIP

老年血液透析患者低血压的原因分析及护理应对措施 张亚真黄秀碧 (福建医科大学附属漳州市医院 福建漳州363000) 【摘要】目的:分析老年患者在血液透析过程中出现低血压的病因以及护理 干预措施。方法：选取2014年1月?2015年12月我院收治的120例进行血液 透析的老年患者，全体患者均接受常规血液透析，选用双醋酸空心纤维透析仪和 碳酸氢盐透析液，血液透析前后检测患者体温、心率、血压等牛命体征，血透期 间，密切监测患者血流量、脱水量、静脉压等，并根据血压测量结果计算平均动 脉压。结果：患者血透期间低血压发牛率为23.1% (835/3621),其中血透进行 0.5—lh内,收缩压骤然下降le;90mmHg或平均动脉压较血透前下降30mmHg, 共计420次。透析3h后发牛低血压共计1250次。超滤量ge;3.5kg的情况下， 低血压发牛920次。全体患者出现低血压症状后，经对症干预，1584次低血压 均得以控制，并顺利复常，故治疗成功率为94.9%o 86次经临床干预后，低血压 症状无明显缓解，故只能终止血液透析，治疗失败率为5.1%,无1例死亡。结 论：通过病因分析，患者采取、密切观察病情、控制患者超滤率、讲解相关知识、 进行心理护理等护理措施，可有效提高患者临床治愈效果。 【关键词】老年患者；血液透析；低血压；护理 【中图分类号】R473.5 【文献标识码】B 【文章编号】1007-8231 (2016) 09-0161-02 Cause analysis of hypotension in elderly hemodialysis patients and nursing coun termeasures Zha ng Yazhen, Hua ng Xiubi. Zha ngzhou Hospital affiliated to Fujia n Medical University, 363000,China 【Abstract] Objective To an a lyze the etiology and nu rsing in terve ntion of hypotension in elderly patients during hemodialysis. Methods January2015 2014 to December 2007 in our hospital treated 120 cases of hemodialysis in elderly patients, all patients underwent conventional hemodialysis, selection of diacetate hollow fiber dialysis machi ne and bicarb on ate dialysate and blood before and after dialysis detect vital signs of the patients body temperature, heart rate, blood pressure, hemodialysis during the close monitoring of the patients blood flow, dehydration, venous pressure and so on, and according to the blood pressure measurements to calculate mean arterial pressure. Results In patients with hemodialysis hypotension during occurrenee rate of 23.1% (835/3621), among them hemodialysis 0. Systolic blood pressure suddenly dropped less than or equal to 90 mmHg or mean arterial pressure than before hemodialysis drop 30mmhg. A total of 420. Hypotension occurred after dialysis for 1250 times a total of times. Ultrafiltration volume was 3.5kg cases, hypotension occurred 920 times. All the patients with low blood pressure symptoms, after symptomatic interv