Departments of Surgery, Máxima Medical Center-Veldhoven, PO box 7777, 5500 MB Veldhoven, The Netherlands.
Nephrology (Carlton). 2010 Aug;15(5):555-9. doi: 10.1111/j.1440-1797.2009.01271.x.
During haemodialysis, some patients experience intensification of symptoms of haemodialysis access-induced distal ischaemia. Aim of this study is to compare the effects of two different regimens of arterial blood flow in patients with an arteriovenous access.
A questionnaire identified 10 patients that subjectively experienced ischaemic symptoms during haemodialysis. Systolic blood pressure, heart rate, finger pressure (P(dig)), finger temperature (T(dig)), oxygen saturation and ischaemic scores were monitored during two different arterial blood flow dialysis sessions.
Before dialysis, P(dig) and T(dig) of the arteriovenous access hand were significantly lower compared with the other hand. Haemodialysis induced a drop of P(dig) in both hands. All changes in P(dig) occurred independent of the artificial kidney's blood flow level.
Systemic hypotension following onset of haemodialysis further intensifies an already diminished hand perfusion. Measures preventing dialytic hypotension will likely attenuate symptoms associated with haemodialysis access-induced distal ischaemia during haemodialysis.
在血液透析过程中，一些患者会出现血液透析通路引起的远端缺血症状加重。本研究旨在比较两种不同的动脉血流方案对动静脉通路患者的影响。
通过问卷调查确定了 10 名在血液透析过程中主观出现缺血症状的患者。在两次不同的动脉血流透析过程中，监测收缩压、心率、手指压力（P(dig)）、手指温度（T(dig)）、氧饱和度和缺血评分。
在透析前，动静脉通路手的 P(dig)和 T(dig)明显低于另一只手。血液透析会导致双手 P(dig)下降。所有 P(dig)的变化都与人工肾的血流水平无关。
血液透析开始后出现的全身性低血压会进一步加重已经减弱的手部灌注。预防透析性低血压的措施可能会减轻血液透析过程中与动静脉通路引起的远端缺血相关的症状。
