血液透析治疗中泵前动脉压与泵控血流量比值的临床研究

莫雅文; 宋利; 韩晓苇; 黄静雅; 孙春艳; 周丽芳; 符霞

doi:10.3969/j.issn.1671-4091.2019.08.018

中国血液净化 >

2019 , Vol. 18 >Issue 08: 579 - 581

DOI: https://doi.org/10.3969/j.issn.1671-4091.2019.08.018

护理研究

血液透析治疗中泵前动脉压与泵控血流量比值的临床研究

莫雅文 ,
宋利 ,
韩晓苇 ,
黄静雅 ,
孙春艳 ,
周丽芳 ,
符霞

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1 南方医科大学护理学院
2广东省人民医院广东省医学科学院肾内科血液净化中心
3深圳市中医院血液净化中心

收稿日期: 2019-04-01

修回日期: 2019-05-22

网络出版日期: 2019-08-15

基金资助

广东省省级科技计划项目(2015A020210071)

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A survey on the ratio of pre-pump arterial pressure and blood flow rate during hemodialysis treatment

MO Ya-Wen ,
SONG Li ,
HAN Xiao-Wei ,
HUANG Jing-Ya ,
SUN Chun-Yan ,
ZHOU Li-Fang ,
FU Xia

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1School of Nursing, Southern Medical University, Guangzhou 510515, China; 2Hemodialysis Center, Department of Nephrology, Guangdong Provincial People’s Hospital / Guangdong Academy of Medical Sciences, Guangzhou 510080, China; 3Division of Nephrology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China

Received date: 2019-04-01

Revised date: 2019-05-22

Online published: 2019-08-15

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摘要

【摘要】目的调查血液透析过程中泵前动脉压与泵控血流量比值的正常范围并探讨其临床意义。方法纳入2 家三甲医院的血液透析患者527 例，收集透析治疗过程中每个小时的泵前动脉压、静脉压、跨膜压等压力检测指标及泵控血流量情况，并分析泵前动脉压(pre-pump arterial pressure，PreAP)绝对值与泵控血流速(blood flow rate, BFR)的相关性及其比值的95%参考值范围。结果泵前动脉压绝对值与泵控血流量呈显著正相关性(b=10.09, t=65.241, Ptrend＜0.001)；PreAP 绝对值与BFR 比值的水平为(0.43±0.12)，95%参考值范围为(0.20，0.66)。结论明确PreAP 与BFR 比值的参考范围可以早期发现和预防内瘘狭窄的发生，为临床护理提供快速筛查的手段，为持续监测和早期干预提供理论依据。当比值持续超出95%参考值范围，提示血管通路功能可能欠佳，需要仔细评估血管通路是否存在狭窄。

关键词： 血液透析; 动脉压; 血流量; 比值

本文引用格式

莫雅文 , 宋利 , 韩晓苇 , 黄静雅 , 孙春艳 , 周丽芳 , 符霞 . 血液透析治疗中泵前动脉压与泵控血流量比值的临床研究[J]. 中国血液净化, 2019 , 18(08) : 579 -581 . DOI: 10.3969/j.issn.1671-4091.2019.08.018

Abstract

【Abstract】Objective To investigate the normal range of the ratio of pre-pump arterial pressure (PreAP) to blood flow rate (BFR) during hemodialysis and to explore its clinical significance. Methods A total of 527 patients with hemodialysis from two tertiary hospitals were enrolled. The pressure measurement indexes of PreAP, venous pressure, transmembrane pressure and BFR were collected every hour in the dialysis session. The correlation of PreAP and BFR, and the 95% reference range of PreAP to BFR ratio were analyzed. Result The absolute value of PreAP was significantly correlated with BFR (b=10.09, t=65.241, Ptrend＜0.001). The statistical description of the absolute value of PreAP to BFR ratio was 0.43±0.12, and the 95% reference range was 0.20, 0.66. Conclusion Defining the reference range of PreAP to BFR ratio can early detect and prevent the stenosis in internal fistulas, and provide a rapid screening tool for clinical care and a theoretical basis for continuous monitoring and early intervention. The ratio continuously to exceed the 95% reference range suggests the poor function of vascular access, requiring to carefully examine whether stenosis is present in the vascular access.

Key words： Hemodialysis; Arterial pressure; Blood flow rate; Ratio

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