高低钠序贯透析在相关性低血压中的应用价值及其护理研究（邯郸市中心医院血液透析室河北邯郸056001）【摘要】目的：探讨高低钠序贯透析法在预防相关性低血压中的应用价值与护理研究。方法：选取104例固定维持血液透析的患者为研究对象，分为观察组52例和对照组52例，观察组应用高低钠序贯透析法，对照组行常规透析。观察透析前、透析过程中两组患者血压、血钠浓度及血清检测值的变化，记录相关性低血压、肌肉痉挛、恶心呕吐等并发症的发生率。结果：观察组患者透析过程中肌肉痉挛、相关性低血压、紧急低血压护理、恶心呕吐和中途停止的发生率均显著低于对照组（P＜0.05）；对照组患者透析过程中收缩压（SystolicBloodPressure,SBP）、舒张压(DiastolicBloodPressure,DBP)、平均动脉压(MeanArterialPressure,MAP)与透析后各项血清检测指标值均显著低于观察组（P＜0.05）。结论：高低钠序贯透析能较好地维持患者血压稳定，预防相关性低血压的发生。个体化的护理干预措施能增加患者对透析治疗的依从性，更好的保证透析质量。【关键词】高低钠；序贯透析；相关性低血压；护理【中图分类号】R47【文献标识码】B【文章编号】1003-5028（2015）7-0093-02Applicationofhighandlowsodiumsequentialdialysishypotensioninthecorrelationvalueandnursingresearch【Abstract】Objective:tostudythecorrelationappliedvalueandnursingresearchofhighandlowsodiumsequentialdialysismethodinpreventionofhypotension.Methods:104casesoffixedmaintenancehemodialysispatientswerechosenastheresearchobject,andwerepidedintoobservationgroupof52casesandcontrolgroupof52cases,observationgroupwasappliedhighandlowsodiumsequentialdialysismethod,thecontrolgroupwasappliedroutinedialysis.Twogroupsintheprocessofobservationbeforedialysis,dialysispatients'bloodpressure,serumsodiumconcentration,andthechangeofserumreadingswereobserved.Theincidenceofcomplicationsofcorrelationrecordlowbloodpressure,musclecramps,nauseaandvomitingwerecounted.Results:theincidenceforpatientswithmusclespasms,relevanceduringtheprocessofdialysishypotension,emergencycareofthehypotension,nauseaandvomiting,andmidwaystopinobservationgroupweresignificantlylowerthanthoseincontrolgroup(P<0.05);theprocessofdialysispatientswithSystolicBloodPressure(SystolicBloodPressure,SBP),DiastolicBloodPressure,DiastolicBloodPressure,DBP),MeanArterialPressure,MeanArterialPressure,MAP)andtheserumindexesafterdialysisinthecontrolgroupweresignificantlylowerthanthoseinobservationgroup(P<0.05).Conclusion:highandlowsodiumsequentialdialysiscanmaintainbloodpressureinpatientscankeepthepressstable,preventthehappeningofthecorrelationoflowbloodpressure.Inpidualizednursinginterventioncanincreasepatientsondialysistreatmentcompliance,andcanbebettertoensurethequalityofdialysis.【Keywords】highandlowsodium;Sequentialdialysis;Correlationoflowbloodpressure;nursing相关性低血压是造成透析病人死亡的高危因素之一[1]，它不仅会造成患者出现头晕、痉挛、恶心、呕吐等临床症状，还会降低透析治疗的耐受性，影响血液透析的进程，降低透析效果[2]。近年来，随着临床透析技术的日益成熟与血液净化技术的不断完善，高低钠序贯透析被广泛应用于相关性低血压的预防。这种透析模式不仅可促进血管的再充盈，确保血容量与血浆渗透压的相对稳定，还可有效预防因脱水速度过快、脱水量过大而引发的血容量快速下降，显著降低透析中相关性低血压的发生率。目前，高低钠序贯透析预防相关性低血压的原因多被认为是其有效防止了脱水超滤率过大、血容量显著降低的现象。但某些患者透析过程中干体重与脱水量均不高，却发生了相关性低血压。针对此类患者，高低钠序贯透析模式也有良好的预防效果。为探讨以上原因，本研究开展了高低钠序贯透析在相关性低血压中的应用价值及其护理研...