Critical Care Nursing
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jccnursing
Medical Sciences
http://jccnursing.com
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تأثیر سرعت جریان خون بر شاخصهای فیزیولوژیک و عوارض دیالیز در بیماران همودیالیزی
Increased Blood Flow and its Effect on Physiological Parameters and Complications of Dialysis in Hemodialysis Patients
تخصصي
Special
پژوهشي
Research
<span style="font-size:12pt"><span style="line-height:87%"><span style="tab-stops:-15.8pt 29.2pt 45.2pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra"">زمینه و هدف:</span></span></span></b> <span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra"">همودیالیز رایجترین شیوه درمانی در مرحله انتهایی نارسایی کلیوی به شمار میرود که علیرغم تلاشهای نظام سلامت، این بیماری و روش درمانی آن، شیوه زندگی و وضعیت سلامتی بیماران را تحت تأثیر قرار میدهد. یکی از شیوههای مؤثر در بهبود کفایت همودیالیز، افزایش سرعت جریان خون و دور دستگاه همودیالیز قلمداد میشود، مطالعه حاضر با هدف تعیین تأثیر افزایش سرعت جریان خون بر شاخصهای فیزیولوژیک و عوارض دیالیز در بیماران همودیالیزی صورت پذیرفت.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:87%"><span style="tab-stops:-15.8pt 29.2pt 45.2pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra"">روش</span></span></span></b><b><span dir="LTR" style="font-size:11.0pt"><span style="line-height:87%"></span></span></b><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra"">ها:</span></span></span></b><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""> این پژوهش یک مطالعه مداخلهای از نوع متقاطع به شیوه قبل و بعد است که تعداد 37 بیمار مراجعهکننده به مرکز همودیالیز به صورت سرشماری وارد مطالعه شدند. پس از ثبت مشخصات جمعیت شناختی بیماران، در دو جلسه سرعت جریان خون بر روی 250 </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%">ml/min</span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""> و در دو جلسه سرعت جریان خون بر روی 350 </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%">ml/min</span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""> تنظیم شد. سپس شاخصهای فشار خون، ضربان قلب و اکسیژن خون شریانی قبل، ساعت وسط و پایان همودیالیز با دور پمپ 250 </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%">ml/min</span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""> و 350 </span></span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%">ml/min</span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra"">اندازهگیری شد و همچنین عوارض همودیالیز حین جلسات پایش و ثبت شد.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:87%"><span style="tab-stops:-15.8pt 29.2pt 45.2pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra"">یافتهها: </span></span></span></b><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black">میانگین تعداد ضربان قلب و میزان اکسیژن</span></span></span></span> <span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black">خون</span></span></span></span> <span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black">شریانی ، فشار</span></span></span></span> <span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black">خون</span></span></span></span> <span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black">سیستولیک و دیاستولیک در دو گروه دیالیز با دور پمپ خون </span></span></span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""> 250 </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%">ml/min</span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""> و 350 </span></span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%">ml/min</span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black"> در همودیالیز اختلاف معنیداری را نشان </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black">نداد </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%"><span style="color:black">(p>0.05)</span></span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black">. همچنین از نظر فراوانی بروز عوارض از قبیل هایپوتانسیون و کرامپ عضلانی </span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black">تفاوت معنیدار آماری بین دو دور پمپ یافت نشد </span></span></span></span> <span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%"><span style="color:black">(p>0.05)</span></span></span><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black">.</span></span></span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:87%"><span style="tab-stops:-15.8pt 29.2pt 45.2pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra"">نتیجهگیری: </span></span></span></b><span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black">دور پمپ خون 350 </span></span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="line-height:87%"><span style="color:black">ml/min</span></span></span> <span lang="FA" style="font-size:11.0pt"><span style="line-height:87%"><span style="font-family:"B Mitra""><span style="color:black">دستگاه همودیالیز میتواند به عنوان یک عامل مؤثر و بدون عارضهی فیزیولوژیک و بالینی در بیماران دیالیزی جهت بهبود کفایت دیالیز استفاده شود.</span></span></span></span></span></span></span></span></span></span>
<div style="text-align: justify;"><span style="font-size:12pt"><span style="line-height:115%"><span style="text-autospace:none"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:10.0pt"><span style="line-height:115%">Background and Aim</span></span></b><span style="font-size:10.0pt"><span style="line-height:115%">:</span></span> <span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:black">Hemodialysis is the most common treatment in the final stage of renal failure that despite the efforts of the health care system, this disease and its treatment method affects the lifestyle and health status of patients. One of the effective methods in improving the adequacy of hemodialysis is to increase the rate of blood flow and the rate of the hemodialysis machine.</span></span></span> <span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:black">The aim of this study was to determine the effect of increasing the speed of blood flow on physiological parameters and complications of dialysis in hemodialysis patients</span></span></span><span dir="RTL" lang="FA" style="font-size:10.0pt"><span style="line-height:115%"><span style="font-family:"B Mitra""><span style="color:black">.</span></span></span></span><span style="font-size:9.0pt"><span style="line-height:115%"></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:115%"><span style="text-autospace:none"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:10.0pt"><span style="line-height:115%">Methods</span></span></b><span style="font-size:10.0pt"><span style="line-height:115%">:</span></span> <span style="font-size:10.0pt"><span style="line-height:115%">The present study was a cross-sectional interventional study (pre and post intervention). For this purpose, 37 patients who had referred to the hemodialysis center were included in the study by census. After recording the demographic characteristics of the patients, the intervention was performed on the participants. In two sessions, the blood flow rate was set to 250 ml/min and in two sessions the blood flow rate was set to 350 ml/min. Then blood pressure, heart rate and arterial blood oxygen indices were measured before, mid-hour of hemodialysis and at the end of hemodialysis with 250 ml/min and 350 ml/min remote pump.</span></span><span dir="RTL" lang="FA" style="font-size:9.0pt"><span style="line-height:115%"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="line-height:115%"><span style="text-autospace:none"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman",serif"><b><span style="font-size:10.0pt"><span style="line-height:115%">Results</span></span></b><span style="font-size:10.0pt"><span style="line-height:115%">:</span></span> <span style="font-size:10.0pt"><span style="line-height:115%"><span style="color:black">Mean heart rate and arterial blood oxygen level, systolic and diastolic blood pressure in the two-dialysis groups with blood pump speed of 250 ml/min and 350 ml/min in hemodialysis did not show a significant difference (p>0.05). In addition, no statistically significant difference was observed between the two pump cycles in regards to the frequency of complications such as hypotension and muscle cramps (p>0.05), no statistically significant difference was found between the two pump cycles (p>0.05).</span></span></span><span dir="RTL" lang="FA" style="font-size:9.0pt"><span style="line-height:115%"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span></span><br>
<b><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif">Conclusion</span></span></b><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif">:</span></span> <span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">A round of 350 </span></span></span><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">ml/min</span></span></span><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black"> hemodialysis machines can be used as an effective and appropriate non-pharmacological agent without any specific physiological complications in dialysis patients.</span></span></span></div>
<strong><span dir="RTL"></span></strong>
همودیالیز, شاخصهای فیزیولوژیک, سرعت جریان خون, عوارض دیالیز
Hemodialysis, Physiological Indicators, Blood Flow, Complications of Dialysis
7
1
http://jccnursing.com/browse.php?a_code=A-10-239-1&slc_lang=fa&sid=1
Mahmoud
Baghban Niko
محمود
باغبان نیکو
mahbanik@gmail.com
10031947532846006465
10031947532846006465
No
Department of Nursing, International Campus Faculty, Shahid Sadoughi University of Medical Sciences, Yazd, Yazd
گروه پرستاری، دانشکده پردیس بین الملل، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران
Khadijeh
Nasiriani
خدیجه
نصیریانی
nasiriani@gmail.com
10031947532846006466
10031947532846006466
No
Department of Nursing, Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Yazd
گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران
Roya
Hamayati
رویا
حمایتی
hemayatiroya@gmail.com
10031947532846006467
10031947532846006467
No
Department of internal medicine, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences Yazd, Iran
گروه داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران
Ahmadreza
Fallah Faraghe
احمدرضا
فلاح فراغه
ahmadreza.fallahfaraghe1928@gmail.com
10031947532846006468
10031947532846006468
Yes
Department of Student Research, School of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences Yazd, Yazd, Iran
گروه کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید صدوقی یزد، یزد، ایران