血液透析中高血压病人透析液温度的合理设置研究

摘要

Objective:To probe into the influence of 4 kinds of different temperatures of dialysis solution on the blood pressure of the patients with hypertension in hemodialysis.Methods:Before dialysis,the body temperature of the patients was set as T by using the self control method,the dialysis fluid temperatures were set at 37 ℃, T+0.5,T,T-0.5.The changes of blood pressure,heart rate,mean arterial pressure,and adverse reactions in every hour were monitored continuously during hemodialysis used the 4 kinds of dialysis fluid.Results:When the dialysis fluid was used at 37 ℃ and T+0.5,the blood pressure was not stable and the frequency of adverse reac-tions was high.The blood pressure,heart rate and mean arterial pressure were relatively stable in T and T-0.5 of dialysis solution,in which T-0.5 was the most stable,less adverse reactions,and patients’comfort score was the lowest(P<0.01).Conclusion:The dialysis fluid temperature was set in patients with hypertension according to the measured body temperature before dialysis or turn down 0.5 ℃ on the basis of measured body tempera-ture,it was conducive to the stability of blood pressure and heart rate,could reduce the incidence of complica-tions in dialysis,improve the patient’s tolerance of dialysis.%[目的]探讨血液透析中高血压病人应用4种不同温度的透析液透析对血压的影响。[方法]采用自身对照的方法,将病人透析前测得的体温设定为T,透析液温度分别设定为：37℃,T+0.5,T,T-0.5,连续监测应用4种温度的透析液透析时每小时血压、心率、平均动脉压及透析不良反应等变化。[结果]应用37℃与T+0.5温度的透析液透析时病人存在血压不稳定,不良反应出现频次较高；应用T与T-0.5透析液透析时血压、心率、平均动脉压相对稳定,其中T-0.5最平稳,不良反应少,并且病人舒适度评分最低(P<0.01)。[结论]血液透析中高血压病人透析液温度根据透析前实测体温设定或在实测体温的基础上调低0.5℃,有利于透析中血压、心率的稳定,减少透析中并发症的发生,提高病人透析的耐受性。