本文選題：生物電阻抗　切入點：殘余腎功能　出處：《安徽醫(yī)科大學》2017年碩士論文

【摘要】：目的:觀察應用生物電阻抗分析法指導新進入血液透析患者透析超濾對患者殘余腎功能的保護作用。方法:選取2014年10月至2016年11月安徽醫(yī)科大學174臨床學院新進入血液透析的120例終末期腎病患者為研究對象,隨機分為試驗組及對照組,隨訪3個月。試驗組應用生物電阻抗分析法指導透析超濾,對照組依據(jù)有無水腫、血壓、透析過程中有無低血壓癥狀及透析間期體重增加量來確定透析超濾量。比較兩組前后的殘余腎功能、24小時尿量、透析不良事件發(fā)生率。結果:兩組殘余腎功能、24小時尿量、收縮壓、舒張壓、白蛋白、血紅蛋白、鈣、磷及PTH水平的基線值差異無統(tǒng)計學意義。試驗組殘余腎功能及24小時尿量明顯高于對照組。試驗組血鈣高于對照組。兩組患者的收縮壓、舒張壓、隨訪期間透析不良事件發(fā)生率、白蛋白、血紅蛋白、磷及甲狀旁腺激素水平的差異無統(tǒng)計學意義。兩組的殘余腎功能及24小時尿量均較基線值下降(P0.05)。兩組血紅蛋白、白蛋白水平均較基線值升高。兩組收縮壓、舒張壓均較基線值降低。兩組血鈣水平均較基線值升高,血磷較基線值升高,甲狀旁腺激素較基線值升高。24小時尿量與殘余腎功能水平相關。透析超濾量與殘余腎功能的下降速度成正相關。透析超濾量與24小時尿量的下降速度成正相關。結論:應用生物電阻抗分析法指導血液透析超濾,能更準確的評估患者容量情況,有助于延緩殘余腎功能的下降。
[Abstract]:Objective: to observe the protective effect of ultrafiltration on residual renal function of newly entered hemodialysis patients by bioelectric impedance analysis. Methods: from October 2014 to November 2016, 174 new clinic of Anhui Medical University was selected. 120 patients with end-stage nephropathy who entered hemodialysis were studied. The experimental group was followed up for 3 months. Bioelectrical impedance analysis was used to guide dialysis ultrafiltration, while the control group was based on edema and blood pressure. Whether there were hypotensive symptoms and weight gain during dialysis to determine the ultrafiltration volume. The 24 hour urine volume and the incidence of adverse events of dialysis were compared between the two groups. Results: the residual renal function in the two groups was 24 hours urine volume. Systolic blood pressure, diastolic blood pressure, albumin, hemoglobin, calcium, There was no significant difference in baseline values of phosphorus and PTH levels. The residual renal function and 24-hour urine volume in the trial group were significantly higher than those in the control group. The blood calcium level in the trial group was higher than that in the control group. The systolic blood pressure and diastolic blood pressure in the two groups were significantly higher than those in the control group. There was no significant difference in the incidence of adverse events, albumin, hemoglobin, phosphorus and parathyroid hormone levels during the follow-up period. The residual renal function and 24-hour urine volume in the two groups were significantly lower than the baseline values (P 0.05). The levels of albumin were higher than baseline values, systolic blood pressure and diastolic blood pressure were lower than baseline values, serum calcium levels and serum phosphorus levels in both groups were higher than baseline values, and serum phosphorus levels were higher than baseline values in both groups. The increase of parathyroid hormone compared with baseline value. 24 hours urine volume was correlated with residual renal function level, dialysis ultrafiltration volume was positively correlated with the rate of residual renal function decline, and dialysis ultrafiltration volume was positively correlated with 24 hour urine volume decline rate. Conclusion: bioelectric impedance analysis is used to guide hemodialysis ultrafiltration. A more accurate assessment of the patient's volume may help to delay the decline in residual renal function.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R692.5

【參考文獻】

相關期刊論文 前10條

1 孫幫杰;馬特安;郭輝;;限定最大超濾率對尿毒癥維持性血液透析患者的影響[J];長江大學學報(自科版);2015年30期

2 徐麗霞;梁馨苓;李志蓮;李銳釗;劉雙信;史偉;;維持性血液透析患者殘余尿量與其透析質量的相關性[J];東南大學學報(醫(yī)學版);2014年04期

3 劉莎;刁宗禮;張東亮;丁嘉祥;崔文英;劉文虎;;不除水對新的血液透析患者殘余腎功能的影響[J];中國血液凈化;2013年07期

4 許邑匡;陳英華;陳鳳珍;;超濾量對維持性血液透析患者殘余腎功能的影響[J];中國醫(yī)藥指南;2013年16期

5 王蕾;;殘余腎功能對血液透析患者鈣磷代謝狀況和死亡率的影響[J];泰山醫(yī)學院學報;2013年02期

6 漆映輝;曲曉璐;唐詠華;戴芹;;殘余腎功能對血液透析患者鈣磷代謝的影響[J];臨床腎臟病雜志;2013年01期

7 韋洮;王梅;燕宇;楊冰;檀敏;;血液透析患者殘余腎功能的變化及其影響因素[J];北京醫(yī)學;2012年04期

8 趙明;李向東;;殘余腎功能對維持性血液透析患者營養(yǎng)狀況及左心功能的影響[J];臨床腎臟病雜志;2011年04期

9 趙靜瑜;吳際;王乃平;;維持性血液透析患者應用不同血液凈化方式對殘余腎功能影響的臨床研究[J];中國血液凈化;2011年02期

10 常守鳳;王儉勤;王文革;張文君;;159例維持性血液透析患者生存分析[J];中國中西醫(yī)結合腎病雜志;2010年08期

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