| Objective:(1)Using bioelectrical impedance analysis(BIA)technology to investigate the difference of body fluid distribution in maintenance hemodialysis patients with different types of blood pressure changes after dialysis,providing theoretical guidance for accurately controlling the dry weight of dialysis patients with different types of blood pressure changes;(2)To compare the effects of BIA technology assisted adjustment of dry weight and clinical assessment method alone on blood pressure control,cardiovascular events and quality of life of dialysis patients with different types of blood pressure changes,providing clinical evidence for refined management of hemodialysis patients.Methods:Using a randomized controlled method,86 patients undergoing maintenance hemodialysis at the Blood Purification Center of the Second Hospital of Shanxi Medical University from January 2022 to June 2022 were selected.According to the changes in systolic blood pressure(SBP)during dialysis,they were divided into three groups: group A with increased blood pressure(△ SBP ≥ 15 mm Hg),group B with stable blood pressure(-20 mm Hg < △ SBP < 15 mm Hg),and group C with decreased blood pressure(△ SBP ≤-20 mm Hg).(1)BIA technology was used to measure and compare the related volume indicators such as overhydration(OH),extracellular water(ECW),intracellular water(ICW),and total body water(TBW)of patients in each group after dialysis;(2)The above three groups were randomly divided into experimental group(A1,B1,C1)and control group(A2,B2,C2).The experimental group used BIA technology to intervene and regulate dry weight,while the control group used clinical assessment method to routinely evaluate and regulate dry weight.After a 6-month adjustment,the two groups were statistically compared:blood pressure control during dialysis,improvement of blood pressure fluctuations during dialysis,occurrence of hypertension and hypotension events,improvement of cardiac function,The incidence of cardiovascular events and improvement in quality of life.Results:(1)Compared with the stable blood pressure group during dialysis,the OH value(2.55±0.42L)and ECW/TBW(0.51±0.01)of the patients in the increased blood pressure group were higher,the OH value(-1.02±0.33L)of the patients in the decreased blood pressure group was lower,and the ICW/TBW(0.58±0.01)was higher.(2)Compared with the clinical assessment method alone,the BIA technology assisted in adjusting dry weight decreased the absolute value of △ SBP,the value of Brain natriuretic peptide(BNP)and the number of adverse blood pressure events during dialysis in the elevated and decreased blood pressure groups.The △SBP value increased before and after the interdialysis experiment(P < 0.05).There were no significant differences in Left ventricular ejection fraction(LVEF),quality of life,or incidence of cardiovascular events(P > 0.05).(3)There was no significant difference between the two methods in patients with stable blood pressure during dialysis(P >0.05).Conclusion:(1)Patients with increased blood pressure after dialysis often have volume overload,and the volume change is mainly increased ECW.In the decreasing blood pressure group,there was often insufficient volume,and the increase of ICW was the main volume change.The volume of patients in the stable blood pressure group was relatively balanced;(2)Compared with the clinical assessment method alone,the use of BIA technology to assist the adjustment of dry weight can reduce the fluctuation of blood pressure during dialysis in both the hypertensive and hypertensive groups,significantly reduce the occurrence of adverse blood pressure events during dialysis,and significantly improve the control of blood pressure during dialysis,as well as the patients’ cardiac function.In patients with stable blood pressure during dialysis,the results of dry weight evaluation by the two methods were consistent. |
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