序贯结肠透析治疗慢性肾功能衰竭合并高尿酸血症患者的效果观察及护理

Investigation and nursing of sequential colon dialysis on CRF patients with hyperuricemia

目的观察序贯结肠透析对慢性肾功能衰竭合并高尿酸血症患者的疗效,探讨其护理方法。方法对91例慢性肾功能衰竭合并高尿酸血症的患者随机分为两组,序贯透析组46例进行序贯结肠透析治疗,血液透析组45例进行血液透析治疗。观察治疗前后血尿酸、肌酐及尿素氮水平的变化及不良反应发生情况。结果序贯透析组46例患者中,血尿酸、肌酐及尿素氮水平显著下降(P<0.05或P<0.01),且降血尿酸效果比降血肌酐、尿素氮效果更佳,总有效率达98%,与血液透析治疗效果无显著性差异(P>0.05)。序贯透析组出现便意、轻度腹痛、大便失禁等不良反应,均较轻,不影响治疗;血液透析组出现低血压、高血压、心绞痛等不良反应,有22例次低血压患者经对症治疗无效,需终止治疗。结论序贯结肠透析对慢性肾功能衰竭合并高尿酸血症患者疗效显著,且不良反应少,安全性好。治疗前对患者进行访视、监测;治疗中及治疗后加强对不良反应的观察与护理,可减轻患者的不适,减少并发症的发生。

Objective To observe the curative effeet of sequential colon dialysis on chronic renal failure （CRF） complicated with hyperuricemia and probe into nursing measures. Methods Forty-six CRF patients with hyperuricemia were treated by sequential colon dialysis. The serum uric acid, ereatinine and urea nitrogen as well as the adverse reaction were observed. Results In all the patients, serum uric acid, creatinine and urea nitrogen were decreased significantly （P〈0.05 or P〈0.01）. Among them, the serum uric acid was most obviously lowered, with a total effective rate of 98%. Compared with the effect of hemodialysis, sequential colon dialysis resulted in the same effect （P〉0.05）. During sequential colon dialysis, such adverse reactions as awareness of defecation, mild abdominalgia. encopresis came out but they were not severe, rendering no influence on treatment. As for those with hemodialysis, such adverse reactions as hypertension, hypotension, angina peetoris occurred. 22 cases of hypotension quitted from treatment due to ineffective treatment. Conclusion Sequential colon dialysis is effective and safe in treating CRF complicated with hyperuricemia. As for nursing care, interviewing and monitoring the patients before treatment, enhanced observation and treatment of the adverse reactions during and after treatment are able to relieve the discomfort of patients and reduce the complications.