血液灌流联合血液透析治疗尿毒症26例观察

The clinical study of combined hemodialysis-hemoperfusion in chronic uremia

目的探讨使用血液灌流治疗尿毒症患者的疗效与安全性。方法维持性血液透析患者26例,采用血液灌流与血液透析(HP/HD)联合治疗方法与单纯血液透析(HD)方法对比(自身对照)。治疗前后检测中分子物质(MMS)、血尿素、肌酐、白蛋白及临床症状。结果血液灌流治疗能显著清除尿毒症患者体内的中分子物质,单次使用治疗2小时后MMS显著下降,单纯血液透析对MMS无影响,两者差异有明显统计学意义(P<0.01)。同时患者睡眠、食欲、皮肤瘙痒有不同程度改善。未发生其它任何副作用。结论作为清除MMS的治疗措施,血液灌流临床使用安全、疗效可靠、无副作用。

Objective To investigate the effect and safety of combined hemodialysis-resin hemoperfusion in uremia. Methods 26 uremia patients were treated with combined hemodialysis-resin hemoperfusion. Middle molecular subatances （MMS）, urea and ereatinine were detected before and after the treatment. Meanwhile, we compared the effect of combined hemodialysis-resin hemoperfusion procedure with conventional hemodialysis in uremic toxin clearance. Results MMS was reduced significantly in combined bemodialysis-hemoperfusion procedure（P〈0.001）. Compared with conventional hemodialysis, a combination of hemoperfusion and hemodialysis had a better effect in MMS clearance（P〈0.001）. Meanwhile, some clinical conditions（appetite, pruritus, insomnia） improved. We did not found any adverse effect. Conclusion Resin hemoperfusion can effectively clean MMS and was confirmed to be a safe and risk-frec procedure.