中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2013年
4期
472-474
,共3页
王康%郭宝春%贺晓蕾%张欣洲
王康%郭寶春%賀曉蕾%張訢洲
왕강%곽보춘%하효뢰%장흔주
肾透析%血压%钠/代谢%血液透析液
腎透析%血壓%鈉/代謝%血液透析液
신투석%혈압%납/대사%혈액투석액
Renal dialysis%Blood pressure%Sodium/metabolism%Hemodialysis solutions
目的 研究传统透析方式中钠清除的特点,探讨患者钠平衡与血压水平的关系.方法 随机选取14例维持性血液透析患者,测定透析前、后血钠水平.透析开始及之后每30分钟取20ml超滤废液,9次共180 ml,混合后取10 ml,估算超滤引起的NaCl清除量以及NaCl的总清除量.按照NaC1清除量的中位数将患者分为2组(≥29 g组和＜29 g组),采用Fisher's Exact Test对不同组别高血压发生率进行比较.结果 单次透析的NaC1清除量为(29±14,9)g,其中超滤的NaCl清除量为(18 ±6.9)g,占(83 ±58.6)％.Fisher's Exact Test结果显示,认为每次透析NaCl清除量＜29 g的患者更容易发生高血压(≥150/90mmHg) (P =0.023).结论 影响血液透析中钠清除的因素非常复杂.超滤是血液透析NaCl清除的主要方式.对于无尿的患者,传统维持性血液透析模式下保证每周足够的超滤量而不是通过限制水的摄入量才是达到人体钠平衡从而更好的控制血压的方法.
目的 研究傳統透析方式中鈉清除的特點,探討患者鈉平衡與血壓水平的關繫.方法 隨機選取14例維持性血液透析患者,測定透析前、後血鈉水平.透析開始及之後每30分鐘取20ml超濾廢液,9次共180 ml,混閤後取10 ml,估算超濾引起的NaCl清除量以及NaCl的總清除量.按照NaC1清除量的中位數將患者分為2組(≥29 g組和＜29 g組),採用Fisher's Exact Test對不同組彆高血壓髮生率進行比較.結果 單次透析的NaC1清除量為(29±14,9)g,其中超濾的NaCl清除量為(18 ±6.9)g,佔(83 ±58.6)％.Fisher's Exact Test結果顯示,認為每次透析NaCl清除量＜29 g的患者更容易髮生高血壓(≥150/90mmHg) (P =0.023).結論 影響血液透析中鈉清除的因素非常複雜.超濾是血液透析NaCl清除的主要方式.對于無尿的患者,傳統維持性血液透析模式下保證每週足夠的超濾量而不是通過限製水的攝入量纔是達到人體鈉平衡從而更好的控製血壓的方法.
목적 연구전통투석방식중납청제적특점,탐토환자납평형여혈압수평적관계.방법 수궤선취14례유지성혈액투석환자,측정투석전、후혈납수평.투석개시급지후매30분종취20ml초려폐액,9차공180 ml,혼합후취10 ml,고산초려인기적NaCl청제량이급NaCl적총청제량.안조NaC1청제량적중위수장환자분위2조(≥29 g조화＜29 g조),채용Fisher's Exact Test대불동조별고혈압발생솔진행비교.결과 단차투석적NaC1청제량위(29±14,9)g,기중초려적NaCl청제량위(18 ±6.9)g,점(83 ±58.6)％.Fisher's Exact Test결과현시,인위매차투석NaCl청제량＜29 g적환자경용역발생고혈압(≥150/90mmHg) (P =0.023).결론 영향혈액투석중납청제적인소비상복잡.초려시혈액투석NaCl청제적주요방식.대우무뇨적환자,전통유지성혈액투석모식하보증매주족구적초려량이불시통과한제수적섭입량재시체도인체납평형종이경호적공제혈압적방법.
Objective To evaluate the role of the sodium removal and explore the relationship of sodium balance and blood pressure in patients with traditional hemodialysis.Methods Fourteen patients with maintenance hemodialysis were randomly enrolled in this study.Serum sodium concentration was measured at the pre-dialysis and post-dialysis.At the beginning of dialysis and every half hour,20 ml waste dialysates were collected,10 ml were drown from total 180 ml waste dialysates that had being mingled for measuring total NaCl removal and the removal caused by ultrafiltration.The Fisher's Exact Test was used to analyze the difference in incidence of hypertension(≥ 150/90 mmHg group or ＜ 150/90 mmHg) between the different NaCl removal groups.Results The total NaCl removal in single hemodialysis session was (29 ±14.9)g,A average of (18 ± 6.9)g sodium was removed by ultrafiltation (83 ± 58.6)％.The patients whose sodium removal in a hemodialysis session were less than 29 g,which were vulnerable to hypertension (≥ 150/90 mmHg group) (P =0.023).Conclusions The factors that effected sodium removal in hemodialysis session were complicated; most of sodium was removed by ultrafiltration of plasma water.These results demonstrated that adequate ultrafiltration volume in triple times a week rather than restriction of fluid intake was the principal factor that controls blood pressure in patients with traditional hemodialysis.
