目的：观察渐进式低温可调钠透析对有低血压倾向高危患者超滤量的影响。方法选择有低血压倾向的高危透析患者60例，随机分为常温常规组、渐进式低温可调钠组各30例，每例患者观察10次，观察比较患者透析前目标超滤量、透后超滤量、透析中低血压发生率及透析提前结束率。结果2组患者透析前目标超滤量比较，差异无统计学意义（P=0.112）；透析后超滤量、低血压发生率及透析提前结束率比较，差异均有统计学意义（P=0.000）。结论渐进式低温可调钠透析可防治透析中低血的发生、增加有低血压倾向高危患者的透后超滤量、提高患者的透析充分性，从而提高其生活质量和存活率。

Objective To observe the effect and safety of progressive low temperature and sodium profile hemodialysis in the prevention of hemodialysis-related hypotension of high risk patients.Methods With self-control method,25 high risk hemodialysis-related patients underwent 10 times of conventional dialysis of normal temperature,sodium profile hemodialysis of low temperature,progressive low temperature and sodium profile dialysis respectively.Blood pressure,ultrafiltration volume,adverse reaction rate and the incidence of hypotension during the dialysis were compared.Results The comparison of systolic and diastolic blood pressure and ultrafiltration volume during and after dialysis among three groups revealed statistic significance(P0.001).There was much lower incidence of hemodialysis-related hypotension in sodium profile hemodialysis of low temperature group and progressive low temperature and sodium profile dialysis group than in conventional dialysis of normal temperature(P0.001) and in progressive low temperature and sodium profile hemodialysis group,the adverse reaction rate reached the lowest(P0.001).Conclusion Sodium profile hemodialysis of low temperature,progressive low temperature and sodium profile dialysis are effective for the prevention of hemodialysis-related hypotension while the later is safer,for with adjustable temperature,there is low incidence of adverse reaction during the dialysis.

急性或慢性肾衰竭尿毒症病人,当合并其他器官功能障碍或衰竭时,临床病情危重,死亡率高.抢救时可采用常规普通血液透析、腹膜透析、持续血液净化等.近2年,我们应用每天血液透析法对部分尿毒症危重病人进行抢救治疗,取得较好效果,现报告如下.