目標：透析中低血壓為血液透析治療常見且嚴重的併發症，將導致生理不適、器官缺血性損傷、透析通路栓塞、加速心血管功能惡化與增加死亡風險。本文旨在探討加壓裝置於預防透析中低血壓之成效。方法：依循Joanna Briggs Institute系統性文獻回顧指引，搜尋台灣期刊論文索引系統、華藝線上圖書館、CINAHL、Cochrane Library、Embase、ProQuest、PubMed、Web of Science共八個中英文資料庫2024年5月以前文獻，鍵入血液透析、加壓、低血壓之MeSH term與同義詞，以布林邏輯、切截字及限制隨機控制試驗等進階檢索技巧，篩選後共納入6篇文獻，以JBI 2023年的隨機控制試驗查核表評讀文獻品質，以Review Manager 5.4版軟體進行統合分析。結果：血液透析中使用加壓裝置之加壓組比常規組有顯著較佳的透析前後收縮壓差(MD = 9.02， p = .02)及透析後心輸出量(MD = 1.13 L/min， p = .01)，透析中低血壓發生率幾近顯著差異(RR = 0.73， p = .06)。結論：現有證據僅來自樣本數偏少的6篇研究，證據力薄弱，建議臨床可針對高風險族群導入加壓裝置，密切評估個案反應，調整與決策最佳氣動加壓方案。

Objectives: Intradialytic hypotension is a common and severe complication of hemodialysis treatment. It can result in physiological discomfort, ischemic organ damage, dialysis access thrombosis, accelerated cardiovascular functional decline, and an increased risk of mortality. This study evaluated the effectiveness of compression devices in preventing intradialytic hypotension. Methods: In accordance with the systematic review guidelines of the Joanna Briggs Institute (JBI), a comprehensive search was conducted across eight databases: the Index of the Taiwan Periodical Literature System, Airiti Library, CINAHL, Cochrane Library, Embase, ProQuest, PubMed, and Web of Science. Articles published before May 2024 were retrieved using MeSH terms and synonyms for "hemodialysis," "compression," and "hypotension," along with Boolean operators, truncation, and limits for randomized controlled trials. Identified documents were screened, and six articles met the inclusion criteria. The quality of the included studies was assessed using the JBI 2023 checklist for randomized controlled trials, and a meta-analysis was performed using Review Manager 5.4 software. Results: The compression group exhibited a significantly greater systolic blood pressure difference (MD = 9.02, p = .02) and higher postdialysis cardiac output (MD = 1.13 L/min, p = .01) compared with the control group. Additionally, a near-significant reduction in the incidence rate of intradialytic hypotension was identified (RR = 0.73, p = .06). Conclusions: Although the evidence of this study was derived from a limited sample of six studies, it suggests that compression devices may benefit patients at high risk of intradialytic hypotension. Therefore, clinical implementation should involve careful monitoring of individual responses and adjustments to identify the optimal pneumatic compression strategy.

血液透析；加壓；透析中低血壓

hemodialysis, compression, intradialytic hypotension