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

【摘要】：目的:觀察應(yīng)用生物電阻抗分析法指導(dǎo)新進(jìn)入血液透析患者透析超濾對(duì)患者殘余腎功能的保護(hù)作用。方法:選取2014年10月至2016年11月安徽醫(yī)科大學(xué)174臨床學(xué)院新進(jìn)入血液透析的120例終末期腎病患者為研究對(duì)象,隨機(jī)分為試驗(yàn)組及對(duì)照組,隨訪3個(gè)月。試驗(yàn)組應(yīng)用生物電阻抗分析法指導(dǎo)透析超濾,對(duì)照組依據(jù)有無(wú)水腫、血壓、透析過(guò)程中有無(wú)低血壓癥狀及透析間期體重增加量來(lái)確定透析超濾量。比較兩組前后的殘余腎功能、24小時(shí)尿量、透析不良事件發(fā)生率。結(jié)果:兩組殘余腎功能、24小時(shí)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(wú)統(tǒng)計(jì)學(xué)意義。試驗(yàn)組殘余腎功能及24小時(shí)尿量明顯高于對(duì)照組。試驗(yàn)組血鈣高于對(duì)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(wú)統(tǒng)計(jì)學(xué)意義。兩組的殘余腎功能及24小時(shí)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(shí)尿量與殘余腎功能水平相關(guān)。透析超濾量與殘余腎功能的下降速度成正相關(guān)。透析超濾量與24小時(shí)尿量的下降速度成正相關(guān)。結(jié)論:應(yīng)用生物電阻抗分析法指導(dǎo)血液透析超濾,能更準(zhǔn)確的評(píng)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(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R692.5

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