血液透析不同时段联合血液灌流对血液透析患者皮肤瘙痒的临床观察

Clinical Observation of Itching of Hemodialysis Patients with Hemodialysis Combined with Blood Perfusion at Different Periods

目的比较血液透析不同时段联合血液灌流对血液透析患者皮肤瘙痒的临床效果。方法选择景德镇市第三人民医院2019年1月-2020年1月进行治疗的46例病历资料十分完整的维持性血液透析伴有皮肤瘙痒患者作为本次研究对象。依据随机对照原则分为两组,每组23例。观察组采取后联合方式治疗,对照组采取前联合方式治疗。观察两组患者治疗后3个月瘙痒治疗效果、治疗前后瘙痒程度评分与实验室指标水平变化情况以及透析期间并发症发生情况。结果观察组治疗后3个月瘙痒治疗总有效率高于对照组,组间对比差异显著(P<0.05);治疗后1个月、3个月观察组瘙痒程度评分、皮肤瘙痒时间均低于对照组,组间对比差异显著(P<0.05);治疗后1个月、3个月观察组尿素氮(BUN)、血肌酐(SCr)、甲状旁腺素(PTH)、β2微球蛋白(β2-MG)水平均低于对照组,组间对比差异显著(P<0.05);观察组透析期间透析器或管路凝血及低血压发生率均低于对照组,组间对比差异显著(P<0.05)。结论血液透析后联合血液灌流的方式治疗皮肤瘙痒疗效显著,实验室指标改善效果更好,并发症发生率更低,可作为优选方案。

Objective This paper aims to compare the clinical effect of hemodialysis combined with blood perfusion on hemodialysis patients’itching.Methods 46 patients with maintenance hemodialysis accompanied by skin itching who had complete medical records from January 2019 to January 2020 in Jingdezhen Third People’s Hospital were selected as the subjects of this study.According to the principle of random control,it was divided into two groups,with 23 cases in each group.The observation group was treated with a combined approach,and the control group was treated with a combined approach.Observe the effect of pruritus treatment,changes in itching score and laboratory index level before and after treatment,and the occurrence of complications during dialysis.Results The total effective rate of pruritus treatment in the observation group 3 months after treatment was higher than that in the control group,and the difference between the groups was significant(P<0.05);the pruritus score and skin itching time in the observation group 1 month and 3 months after treatment were both lower than those in the control group,the differences between the groups were significant(P<0.05);the urea nitrogen(BUN),blood creatinine(SCr),parathyroid hormone(PTH),β2 microglobulin(β2-MG),observation group 1 month and 3 months after treatment were lower than those in the control group,the difference between the groups were significant(P<0.05);the observation group dialysis or line coagulation and hypotension during dialysis were lower than those in the control group,the difference between the groups were significant(P<0.05).Conclusion After hemodialysis combined with blood perfusion,the effect of treating skin pruritus is obvious,the laboratory index improvement effect is better,and the incidence of complications is lower,which can be used as the optimal plan.