夜间血液透析对维持性血液透析患者透析并发症和耐受性的影响

目的 比较夜间血液透析（NHD）和传统血液透析（CHD）患者透析并发症和耐受性的差异。方法 选取第二军医大学长征医院NHD和CHD患者各72例，收集两组患者的临床资料，记录透析后恢复时间，并对其透析时低血压及透析后疲乏、瘙痒、肌肉痉挛、头晕、头痛、食欲下降、恶心、呕吐、睡眠障碍等身体不适，以及担心死亡、担心设备故障、失去自由、失去工作等心理上的压力和生活状况共20项指标进行问卷调查。结果 与CHD组比较，NHD组患者透析后恢复时间短（P<0.01），透析期间低血压以及透析后疲乏、瘙痒、头晕、头痛、食欲下降、恶心、呕吐等并发症减少（P<0.05，P<0.01），失去自由的人数减少（P<0.01），但担心设备故障的人数增多（P<0.01）。结论 NHD比CHD的血液透析相关并发症少，更能有效提高维持性血液透析患者的耐受性。
Objective To compare the differences of dialysis complications and tolerability between nocturnal hemodialysis (NHD) and conventional hemodialysis (CHD) patients. Methods Seventy-two NHD and 72 CHD patients from Changzheng Hospital of Second Military Medical University were enrolled in this study. The clinical data were collected and the postdialysis recovery time was recorded. The complications including intradialytic hypotension, postdialytic fatigue, itching, muscle spasms, dizziness, headache, loss of appetite, nausea, vomiting, and sleep disorders, and the mental pressure and daily life (fear of death, worrying about equipment failure, losing freedom, and failing to work) were all investigated using a questionnaire. Results Patients in the NHD group had significantly shortened postdialysis recovery time (P<0.01) and significantly less complications (intradialytic hypotension, postdialytic fatigue, itching, dizziness, headache, loss of appetite, nausea and vomiting) than those in the CHD group (P<0.05, P<0.01). The number of patients who lost freedom significantly was decreased (P<0.01), but the number of patients worrying about equipment failure was significantly increased (P<0.01). Conclusion The NHD patients have less complications associated with hemodialysis than CHD patients, and they also have improved tolerance to maintenance hemodialysis