摘要
目的研究超滤量的大小与维持性血液透析患者透析期间血压变化的关系。方法方便抽样选取我院2017年12月1-31日的159例维持性血液透析患者的1 937次治疗数据,根据超滤量的大小分为高超滤量组和正常超滤量组,分析两组患者在透析期间血压的变化,探索超滤量与血压波动的关系。结果两组患者透析期间收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、脉搏和脉压差均呈下降趋势;高超滤量组患者的收缩压、脉搏和脉压差在透析2h及以后比正常超滤组明显降低(P<0.01),舒张压和平均动脉压在透析3h及以后较正常超滤量组明显降低(P<0.01);高超滤量组患者透析前后收缩压、舒张压、平均动脉压及脉搏的差值绝对值大于正常超滤组(P<0.01);高超滤量组患者的异常压发生率较高于正常超滤组(P<0.01)。结论血液透析患者在透析过程中血压逐渐下降,高超滤量的血液透析患者血压波动大,更易发生高血压和低血压事件,透析期间要加强对超滤量>2 500mL患者的血压监测。
Objective To study the relationship between the amount of ultrafiltration volume and the change of blood pressure during hemodialysis in maintenance hemodialysis patients.Methods The 1937 hemodialysis sections of 159 maintenance hemodialysis patients in a tertiary hospital in Shanghai were selected and divided into hyper-ultrafiltration volume group and normal ultrafiltration volume group according to the amount of ultrafiltration volume.The changes in blood pressure during the dialysis period for patients in two groups was analyzed.The relationship between ultrafiltration volume and blood pressure fluctuations was studied.Results The systolic blood pressure,diastolic blood pressure,mean arterial pressure,pulse and pulse pressure was all showed a downward trend in both groups.The systolic blood pressure,pulse pressure and pulse pressure in hyper-ultrafiltration group were significantly lower at the 2 hours and later(P<0.01).There was significant difference in diastolic blood pressure and mean arterial pressure of two groups at the 3 hours and later(P<0.01).The difference of systolic pressure,diastolic pressure and mean arterial pressure between pre-dialysis and post-dialysis is larger(P<0.01).The occurrence rate of abnormal blood pressure occurred in hyper-ultrafiltration group is higher(P<0.01).Conclusion Blood pressure gradually decreases during dialysis,and hyper-ultrafiltration group fluctuates more greatly and more prone to hypertension and hypotension,and strengthen blood pressure monitoring in patients with ultrafiltration volume >2 500 ml.
作者
王欣
曹艳佩
杨晓莉
黄碧红
卢文文
Wang Xin;Cao Yanpei;Yang Xiaoli;Huang Bihong;Lu Wenwen(Huashan Hospital Affiliated to Fudan University,Shanghai 400032)
出处
《护士进修杂志》
2019年第4期289-293,共5页
Journal of Nurses Training
基金
上海市卫生和计划生育委员会科研课题(编号:201640126)
复旦大学-复星护理科研基金(编号:FNF201718)
关键词
维持性血液透析
超滤量
血压
透析间期体质量增长
Maintenance hemodialysis
Ultrafiltration volume
Blood pressure
Interdialytic weight gain
