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目的观察参麦注射剂联合50%葡萄糖注射剂用于预防维持性血液透析患者发生低血压的疗效。方法 46例在维持血液透析中发生低血压的患者(6个月血透中发生低血压反应比例>50%),随机分成2组,各23例。对照组在血液透析时给予50%葡萄糖注射剂100 m L持续静脉滴注;观察组在给予50%葡萄糖注射剂100 m L的基础上,在每次透析开始时给予参麦注射剂50 m L缓慢静脉滴注。记录观察组和对照组在维持性血液透析3个月内发生低血压的次数以及透析前、透析2 h及透析后的收缩压及心率。结果观察组血液透析相关性低血压发生率(14.7%)明显低于对照组(34.9%);观察组透析2h、透析后的收缩压、平均动脉压均高于对照组(P<0.05)。2组透析前、透析2 h及透析后的心率之间差异未见统计学意义(P>0.05)。观察组在预防血透相关性低血压的总有效率(87.0%)明显高于对照组(60.9%),差异具有统计学意义(P<0.05)。结论参麦注射剂联合50%葡萄糖注射剂能有效预防血透相关性低血压,从而保证了透析的充分性,提高了透析的质量。
Objective To observe the effect of Shenmai injection combined with 50% glucose injection in the prevention of hypotension in maintenance hemodialysis patients. Methods Forty-six patients were divided into two groups (n = 23 in each group) while maintaining hypotension in hemodialysis patients (hypotensive response rate> 50% in hemodialysis at 6 months). The control group was given continuous infusion of 50% dextrose injection 100 m L during hemodialysis. The observation group received 50 m L slow intravenous infusion of Shenmai injection at the beginning of every dialysis on the basis of 100 m L 50% glucose injection, Note. The number of hypotension and the systolic blood pressure and heart rate of the observation group and the control group within 3 months of maintenance hemodialysis and before dialysis, dialysis 2 h and after dialysis were recorded. Results The incidence of hemodialysis-related hypotension (14.7%) in the observation group was significantly lower than that in the control group (34.9%). After dialysis for 2 hours, the systolic blood pressure and mean arterial pressure were significantly higher in the observation group than those in the control group (P <0.05). There was no significant difference between the 2 groups before dialysis, the dialysis 2 h and the heart rate after dialysis (P> 0.05). The total effective rate (87.0%) in the observation group in preventing hemodialysis-related hypotension was significantly higher than that in the control group (60.9%), with statistical significance (P <0.05). Conclusion Shenmai injection combined with 50% glucose injection can effectively prevent hemodialysis-related hypotension, thus ensuring the adequacy of dialysis and improving the quality of dialysis.