海南医科大学学报

目的:探讨糖尿病肾病血液透析低血压发生的临床因素及护理干预对透析低血压的积极作用。方法:选取我科糖尿病肾病维持性血液透析治疗中发生低血压患者51例为观察组,设立同期49例糖尿病肾病维持性血液透析治疗患者未发生低血压者为对照组,对比两组患者治疗期间Glu、HbAlc、Hb、Scr、BUN、Na+、Alb、TC、TG等指标的变化。同时对两组患者施以个体化的护理干预。结果:首次血透时观察组BUN、Scr明显高于对照组,Ccr明显低于对照组,两组指标比较有统计学差异(P<0.05);HbAlc、Glu观察组明显高于对照组,有统计学差异(P<0.05);Hb、Na+、Alb明显低于对照组,有统计学差异(P<0.05),而BUN、TG、Scr、TC之间无统计学差异(P>0.05)。结论:糖尿病肾病透析性低血压发生与贫血、高血糖、血钠浓度、营养不良等有关,应提倡个体化透析。透析治疗期间加施以护理干预可提高患者的生活质量,达到预定的透析目的。

Objective:To investigate the risk factors and nursing intervention of hypotension in patients with diabetic nephropathy during hemodialysis.Methods: Fifty-one patients with diabetic nephropathy that experienced hypotension during the process of hemodialysis were enrolled into the study,and 49 patients without hypotension served as control group.Nursing intervention was conducted.Changes in Glu,HbAlc,Hb,Scr,BUN,Na+,Alb,TC,TG and other parameters were observed and compared.Results:During the first hemodialysis,BUN,Scr levels of the observation group were significantly higher,while Ccr level was significantly lower than that of the control group(P<0.05);HbAlc,Glu level of the observation group were significantly higher,and Hb,Na+,Alb were significantly lower than the control group(All P<0.05).No significant difference in the BUN,TG,Scr,TC was observed between two groups(P>0.05).Conclusions: Hypotension occurred in patients with diabetic nephropathy during hemodialysis is related with various factors including anemia,increased blood sugar,serum sodium concentration,malnutrition etc.Thus individualized hemodialysis is needed.Nursing intervention can help to improve patients' life quality.