{"title":"血液透析过程中的常见并发症单一中心体验","authors":"E. Habas","doi":"10.26420/AUSTINJNEPHROLHYPERTENS.2019.1078","DOIUrl":null,"url":null,"abstract":"Background: Hemodialysis (HD) is a renal replacement modality that widely used in End Stage Renal Disease (ESRD) therapy. HD complications occur during HD, post-HD session, and at long term. Aim of the Study: To assess frequency of common complications that occur during HD-session. Method and Patients: Study planned to assess the complications happened during HD-session for 335 patients. All patients had been informed about study aim. All patients included had not any evidence of HBV, HCV or HIV infection. Patient had their weight, blood pressure, pulse, Random Blood Sugar (RBS) and body temperature before they sat on HD-bed. Regular checkup of vital signs every 30 minutes. Any change of these parameters were recorded. Other parameters as hypoglycemic feature, hypotension, rigor, hotness and others were noted. Statistical Analysis: After data collection and arrangement in Excel sheet of Microsoft Office version 16, frequency and average of the parameters are calculated by IBM-SPSS version 25 (SPSS, Chicago, IL, USA) statistical package. Results: Three hundred thirty-five patients enrolled. They were 132 females and 203 male patients, aged 31- 56 years (48 ± 5.2), and weight range was 51-76 Kg (66 ± 3.4). There were 156 patients; 46 hypertensive, 62 diabetics, and 48 diabetics and hypertensive. The rest were not hypertensive or diabetic. Vomiting reported in (61.8%) of patients; during 1 st hour, vomiting occurred in (40.9%) of patients. During 2 nd and at 3 rd hour of HD-session, patients had vomiting almost the same number during this time of HD session. Epigastric mostly three sessions per week. They were 132 females and 203 male patients (Figure 1). Their age average 48 ± 5.2 (sem) with a range of 31 to 56 years. Weight average was 66 Kg ± 3.4 with a range of 51-76 Kg. one hundred and six patients either hypertensive, diabetic or both diabetic and hypertensive (46, 62, 48 patients) respectively, 170 patients were not hypertensive or diabetic. All patients had 3 hours’ HD session with mean of inter-dialytic weight increase of 2.3 ± 5.4 Kg. A case sheet for every patient for 6 sessions were prepared for the studied complications and given to duty doctor and technician to Conclusion: Vomiting is the commonest complication and low RBS. Hotness and hypotension were not also uncommon. Early start of HD, better control of dialysate temperature, strict infection control, and regular vital signs on short time basis and using glucose containing dialysate solutions are major issues to minimize these acute HD complications.","PeriodicalId":91451,"journal":{"name":"Austin journal of nephrology and hypertension","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2019-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"Common Complications during Hemodialysis Session; Single Central Experience\",\"authors\":\"E. Habas\",\"doi\":\"10.26420/AUSTINJNEPHROLHYPERTENS.2019.1078\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background: Hemodialysis (HD) is a renal replacement modality that widely used in End Stage Renal Disease (ESRD) therapy. HD complications occur during HD, post-HD session, and at long term. Aim of the Study: To assess frequency of common complications that occur during HD-session. Method and Patients: Study planned to assess the complications happened during HD-session for 335 patients. All patients had been informed about study aim. All patients included had not any evidence of HBV, HCV or HIV infection. Patient had their weight, blood pressure, pulse, Random Blood Sugar (RBS) and body temperature before they sat on HD-bed. Regular checkup of vital signs every 30 minutes. Any change of these parameters were recorded. Other parameters as hypoglycemic feature, hypotension, rigor, hotness and others were noted. Statistical Analysis: After data collection and arrangement in Excel sheet of Microsoft Office version 16, frequency and average of the parameters are calculated by IBM-SPSS version 25 (SPSS, Chicago, IL, USA) statistical package. Results: Three hundred thirty-five patients enrolled. They were 132 females and 203 male patients, aged 31- 56 years (48 ± 5.2), and weight range was 51-76 Kg (66 ± 3.4). There were 156 patients; 46 hypertensive, 62 diabetics, and 48 diabetics and hypertensive. The rest were not hypertensive or diabetic. Vomiting reported in (61.8%) of patients; during 1 st hour, vomiting occurred in (40.9%) of patients. During 2 nd and at 3 rd hour of HD-session, patients had vomiting almost the same number during this time of HD session. Epigastric mostly three sessions per week. They were 132 females and 203 male patients (Figure 1). Their age average 48 ± 5.2 (sem) with a range of 31 to 56 years. Weight average was 66 Kg ± 3.4 with a range of 51-76 Kg. one hundred and six patients either hypertensive, diabetic or both diabetic and hypertensive (46, 62, 48 patients) respectively, 170 patients were not hypertensive or diabetic. All patients had 3 hours’ HD session with mean of inter-dialytic weight increase of 2.3 ± 5.4 Kg. A case sheet for every patient for 6 sessions were prepared for the studied complications and given to duty doctor and technician to Conclusion: Vomiting is the commonest complication and low RBS. Hotness and hypotension were not also uncommon. Early start of HD, better control of dialysate temperature, strict infection control, and regular vital signs on short time basis and using glucose containing dialysate solutions are major issues to minimize these acute HD complications.\",\"PeriodicalId\":91451,\"journal\":{\"name\":\"Austin journal of nephrology and hypertension\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-01-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Austin journal of nephrology and hypertension\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.26420/AUSTINJNEPHROLHYPERTENS.2019.1078\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Austin journal of nephrology and hypertension","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.26420/AUSTINJNEPHROLHYPERTENS.2019.1078","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 3
摘要
背景:血液透析(HD)是一种广泛应用于终末期肾病(ESRD)治疗的肾脏替代方式。HD并发症发生在HD期间、HD后以及长期。研究目的:评估hd治疗期间常见并发症的发生频率。方法与患者:本研究拟对335例患者进行hd治疗期间的并发症评估。所有患者都被告知研究目的。所有纳入的患者没有任何HBV、HCV或HIV感染的证据。患者坐床前测量体重、血压、脉搏、随机血糖(RBS)和体温。每30分钟定期检查一次生命体征。记录这些参数的任何变化。其他参数如低血糖、低血压、严密性、体温等进行记录。统计分析:数据在Microsoft Office version 16的Excel表格中收集整理后,使用IBM-SPSS version 25 (SPSS, Chicago, IL, USA)统计软件包计算参数的频率和平均值。结果:纳入了335例患者。其中女性132例,男性203例,年龄31 ~ 56岁(48±5.2),体重51 ~ 76 Kg(66±3.4)。共有156例患者;46例高血压,62例糖尿病,48例糖尿病合并高血压。其余的没有高血压或糖尿病。61.8%的患者出现呕吐;第1小时出现呕吐(40.9%)。在HD阶段的第2小时和第3小时,患者呕吐次数几乎相同。上腹部每周大约三次。其中女性132例,男性203例(图1),年龄31 ~ 56岁,平均48±5.2岁(sem)。体重平均为66 Kg±3.4,范围为51-76 Kg。高血压、糖尿病或糖尿病合并高血压者分别为46例、62例、48例,非高血压、非糖尿病者170例。所有患者透析时间均为3小时,透析间期体重平均增加2.3±5.4 Kg。针对所研究的并发症,为每位患者准备了6个疗程的病例表,并交给值班医生和技术人员。结论:呕吐是最常见的并发症,RBS较低。发热和低血压也不罕见。早期开始HD,更好地控制透析液温度,严格控制感染,短时间内规律生命体征,使用含葡萄糖的透析液是减少这些急性HD并发症的主要问题。
Common Complications during Hemodialysis Session; Single Central Experience
Background: Hemodialysis (HD) is a renal replacement modality that widely used in End Stage Renal Disease (ESRD) therapy. HD complications occur during HD, post-HD session, and at long term. Aim of the Study: To assess frequency of common complications that occur during HD-session. Method and Patients: Study planned to assess the complications happened during HD-session for 335 patients. All patients had been informed about study aim. All patients included had not any evidence of HBV, HCV or HIV infection. Patient had their weight, blood pressure, pulse, Random Blood Sugar (RBS) and body temperature before they sat on HD-bed. Regular checkup of vital signs every 30 minutes. Any change of these parameters were recorded. Other parameters as hypoglycemic feature, hypotension, rigor, hotness and others were noted. Statistical Analysis: After data collection and arrangement in Excel sheet of Microsoft Office version 16, frequency and average of the parameters are calculated by IBM-SPSS version 25 (SPSS, Chicago, IL, USA) statistical package. Results: Three hundred thirty-five patients enrolled. They were 132 females and 203 male patients, aged 31- 56 years (48 ± 5.2), and weight range was 51-76 Kg (66 ± 3.4). There were 156 patients; 46 hypertensive, 62 diabetics, and 48 diabetics and hypertensive. The rest were not hypertensive or diabetic. Vomiting reported in (61.8%) of patients; during 1 st hour, vomiting occurred in (40.9%) of patients. During 2 nd and at 3 rd hour of HD-session, patients had vomiting almost the same number during this time of HD session. Epigastric mostly three sessions per week. They were 132 females and 203 male patients (Figure 1). Their age average 48 ± 5.2 (sem) with a range of 31 to 56 years. Weight average was 66 Kg ± 3.4 with a range of 51-76 Kg. one hundred and six patients either hypertensive, diabetic or both diabetic and hypertensive (46, 62, 48 patients) respectively, 170 patients were not hypertensive or diabetic. All patients had 3 hours’ HD session with mean of inter-dialytic weight increase of 2.3 ± 5.4 Kg. A case sheet for every patient for 6 sessions were prepared for the studied complications and given to duty doctor and technician to Conclusion: Vomiting is the commonest complication and low RBS. Hotness and hypotension were not also uncommon. Early start of HD, better control of dialysate temperature, strict infection control, and regular vital signs on short time basis and using glucose containing dialysate solutions are major issues to minimize these acute HD complications.