CAJ | 학술논문

目的探讨血液透析(HD)治疗中低血糖的发生情况,防止血液透析中低血糖的发生.方法 50例维持性血液透析患者,其中糖尿病25例、非糖尿病25例,均采用标准碳酸氧盐无糖透析液进行血液透析.患者于正常饮食后开始HD治疗,HD期间不进食,分别于透析0、1、2、3、4 h检测血糖.结果共有15例患者HD期间血糖低于4.0 mmol/L,其中糖尿病11/25例(44%);非糖尿病4/25例(16%),差异有显著性(P=0.031);7例无任何自觉症状;糖尿病患者中,HD前应用胰岛素者发生低血糖7/9例(77.8%),未使用者发生低血糖4/16(25%)例,差异有显著性(P=0.017).结论 HD过程中糖尿病患者容易出现低血糖并且不易觉察,糖尿病透析前应用胰岛素者在HD过程中更易发生低血糖.对于HD过程中不宜进食的糖尿病患者HD前应停用胰岛素治疗.
목적 탐토혈액투석(HD)치료중저혈당적발생정황,방지혈액투석중저혈당적발생.방법 50례유지성혈액투석환자,기중당뇨병25례、비당뇨병25례,균채용표준탄산양염무당투석액진행혈액투석.환자우정상음식후개시HD치료,HD기간불진식,분별우투석0、1、2、3、4 h검측혈당.결과 공유15례환자HD기간혈당저우4.0 mmol/L,기중당뇨병11/25례(44%);비당뇨병4/25례(16%),차이유현저성(P=0.031);7례무임하자각증상;당뇨병환자중,HD전응용이도소자발생저혈당7/9례(77.8%),미사용자발생저혈당4/16(25%)례,차이유현저성(P=0.017).결론 HD과정중당뇨병환자용역출현저혈당병차불역각찰,당뇨병투석전응용이도소자재HD과정중경역발생저혈당.대우HD과정중불의진식적당뇨병환자HD전응정용이도소치료.
Objective To assess the influenee of hemodialysis on plasma glucose. Methods 50 pa-ticnts with chronic renal failure ineluded 25 diabetic patients and 25 non diabetic patients were hemodialyzed u-sing standard glueose-free dialysis fluid. They ate prior to dialysis and were asked not to eat during hemodialysis. Blood glucose of 0 h, 1 h,2 h,3 h,4 h, were measured at regular intervals during dialysis. Results Plasma glu-cose fell below 4.0 mmol/L(72 mg/dl) in 15 of 50 patients include 11of the 25 diabetic patients and 4 of the 25 nondiabetic patients. The difference was significant There were 7 patients showed no symptom of hypoglycemia. 7 of the 9 diabetic patients oeeured hypoglycemia who were on insulin before hemodialysis,while 4 of the 16 dia-betic patients did who were not on insulin. The difference was significant. Conclusion Patients undergoing be-modialysis may become hypoglyeemie and not be aware of it. Diabetic patients who are on insulin before hemodi-alysis are prone to occulting hypoglycemia. Diabetic patients who can not eat during dialysis should not use insu-lin before hemodialysis.