高通量透析与维持性血液透析的疗效观察

Curative Effects Observation of High Flux Dialysis and Constant Hemodialysis

目的探讨高通量透析改善维持性血液透析患者营养状况的作用机制。方法将55例维持性透析患者随机分为高通量(HPD)组与常规血液透析(CHD)组,HPD组使用聚砜膜F60高通量透析器,CHD组使用低通量F6透析器治疗,观察透析前、后两组患者血K+、、Na+、Cl-、Ca2+、P3-、BUN、Cr、PTH、Hb、HCT。治疗1年后,复测血P3-、BUN、Cr、PTH、Hb、HCT,及两组存在的并发症。结果HPD组与CHD组相比,BUN、Cr清除率无显著差异;HPD组与CHD相比,并发症发生率差异具有显著性(P<0.05);HPD组与CHD组相比,Hb、HCT差异具有显著性(P<0.05)。结论HPD可改善维持性透析患者营养状况,提高患者生存质量,延长患者存活时间。其机制与HPD能清除一些不易被CHD清除的大、中分子尿毒症毒素物质有关。

Objective To probe the mechanism of high flux dialysis improving the nutrition condition of patients with hemodialysis. Methods 55 cases of patients needing constant hemodialysis were assigned to the high flux dialysis group and the constant hemodialysis group. The former group used F60 high flux dialyser and the later used F6 low flux dialyser, then the levels of K+, Na+, Cl-, Ca 2+ , P 3- , BUN, Cr, PTH, Hb, HCT in blood were measured before and after treatment. One year later, the levels of P3-, BUN, Cr, PTH, Hb, HCT were measured again, the complications were also observed. Results Comparing the two groups, there were no significant differences in the clearances of BUN, Cr. But there were significant differences in complications occurrence and levels of Hb, HCT in blood. Conclusions High flux dialysis can improve the nutrition condition of patients with hemodialysis, raise life qualities, and prolong surviving time. The mechanism may be related to the clearing of big or moderate molecules toxic matters.