目的 探讨联机血浆钠浓度监测的准确性，观察个体化低钠透析模式对患者水钠平衡、血压的影响及透析过程中不良反应。方法 选择40例维持性血液透析患者，联机血钠监测及生化法测得血钠浓度对比，并对每例患者各行标准钠透析及个体化低钠血液透析。对两种透析模式透析前后血浆钠浓度等临床指标及不良反应进行比较。结果 联机血钠监测与生化法所测血钠浓度无统计学差异；个体化低钠透析模式血钠浓度、收缩压、口渴程度均明显降低，不良事件发生率低。结论 联机血钠监测测得的血浆钠浓度与常规生化分析结果相关性好；个体化低钠透析模式能明显降低透后血钠浓度、收缩压、口渴程度及透析期间体重增长，不良事件发生率低，安全性好。

Objective The aim of the study was to discuss the accuracy of online monitoring serum sodium concentration and to observe the effect on water and sodium balance, blood pressure and adverse reaction of the hemodialysis patients who received individualized low-sodium dialysis mode. Method We studied 40 maintenance hemodialysis patients during March 2013 to May 2013 in our Unit. Each patient received individualized low-sodium dialysis after standard sodium dialysis. Clinical indexs including serum sodium concentration and adverse reaction were compared between the two dialysis modes. Results There was no statistical difference in the serum sodium concentration between online monitoring and biochemical method. Compared with the standard sodium dialysis, serum sodium level, systolic blood pressure and degree of thirst were significantly reduced in individualized low-sodium dialysis mode with low incidence of adverse events. Conclusion There was a good correlation between online monitoring serum sodium concentration and conventional biochemical analysis result. Serum sodium level , systolic blood pressure, degree of thirst and interdialytic weight gain could be significantly reduced in individualized low-sodium dialysis mode which shows excellent security with low incidence of adverse events.