【摘要】目的探讨氧疗联合低温血液透析(hemodialysis,HD)对透析性低血压(intradialytic hypotension, IDH)的影响。方法选取84 例HD 患者，采用前后自身对照法分为2 个阶段，I 阶段行单纯低温血液透析，II 阶段氧疗联合低温血液透析，均持续8 周。2 个阶段均分别监测透析过程中发生低血压的频率，并检测2 阶段的生化和血气参数。结果氧疗联合低温血液透析明显降低了IDH 的发作次数(从3.16±2.57 到1.98±1.84，t=4.030，P =0.001)。血清白蛋白在2 阶段存在微小差异，差异有统计学意义(I、II 阶段分别为(33.2± 2.9)和(32.3±2.5)g/L，t=2.154，P =0.033)。血气分析结果显示，与无氧疗阶段相比，氧疗显著降低了总二氧化碳(t=8.765，P＜0.001)和碳酸氢根(t=10.820，P＜0.001)，提高了pH值(t=18.330，P＜0.001)。结论氧疗联合低温血液透析对IDH 有更好的疗效，且能在一定程度上维持HD 中的代谢酸碱平衡。

【Abstract】Objective To investigate the effect of oxygen therapy combined with Hemodialysis (HD) on dialysis hypotension (IDH). Methods Eighty-four hemodialysis patients were selected and divided into two stages by self-control method. Stage I was treated with simple hypothermic hemodialysis, stage II oxygen therapy combined with hypothermic hemodialysis for 8 weeks. Two phases monitor the frequency of hypotension during dialysis and detect two-stage biochemical and blood gas analysis parameters. Results Oxygen therapy combined with hypothermic hemodialysis significantly reduced the number of episodes of IDH (from 3.16±2.57 to 1.98±1.84, t=4.030, P=0.001). There was a small difference in serum albumin between the two stages but it was statistically significant [stages I and II were (33.2±2.9) and (32.3±2.5)g/L, t=2.154, P=0.033]. The blood gas analysis showed that compared with the no oxygen therapy stage, Oxygen therapy significantly reduced TCO2 (t =8.765, P＜0.001) and HCO3- (t=10.820, P＜0.001) and increased pH (t=18.330, P＜0.001). Conclusion Oxygen therapy combined with hypothermic hemodialysis has a better effect on IDH and can maintain the metabolic acid-base balance in hemodialysis to a certain extent.