三种血液净化方式治疗尿毒症并发症疗效对比

Therapeutic Effect Comparison among Three Dialysis for Uremia

目的探讨血液灌流串联血液透析、血液透析滤过、普通血液透析治疗尿毒症在高血压、皮肤瘙痒、肾性贫血方面的疗效。方法将45例尿毒症行维持性血液透析(MHD)的患者随机分为血液灌流串联血液透析(HP+HD)组、血液透析滤过(HDF)组和常规血液透析(HD)治疗组。HP+HD组患者每周进行常规HD2次和1次HP+HD;HDF组患者每周常规HD2次和1次HDF;常规HD组每周3次常规HD,每次透析时间均为4h。其他治疗措施均相同。比较三组患者治疗前后平均血压、皮肤瘙痒程度评分、血红蛋白(Hb)和红细胞比容(Hct)的变化。结果HP+HD组和HDF组患者经过3个月的治疗较常规HD组患者血压下降、皮肤瘙痒程度减轻、血红蛋白及红细胞比容升高,差异均有显著性(P<0.05);HP+HD组与HDF组比较差异也有显著性(P<0.05)。结论尿毒症患者在常规HD治疗的同时定期接受HP或HDF治疗,可改善维持性透析患者顽固性高血压、皮肤瘙痒、贫血,提高患者生存质量。尤以HP+HD更为有效。

Objective To compare the effect among combined hemodialysis-hemoperfusion,hemodiafiltration and conventional hemodialysisn on hypertension, skin pruritus, anemia in maintenance hemodialysis patients, to find an effective treatment method. Methods 45 maintenance hemodialysis patients were divided randomly into three groups,respectively treated with combined hemodialysis-hemoperfusion, hemodiafiltration and conventional hemodialysis. Observe the change of blood pressure, score of skin pruritus, the level of hemoglobin and hematocrit value between pretherapy and post-treatment. Results After three months＇ treatment, blood pressure,score of skin pruritus are downer in groups of HP＋HD,HDF than HD （P〈0.05）, the level of hemoglobin and hematocrit value are higher in groups of HP＋HD,HDF than HD （P〈0.05）. Among three groups HP＋HD is the best. Conclusion Maintenance hemodialysis patients received regular hemodialysis added with liP, HDF can effectively clean middle molecule toxins, then hypertension,skin pruritus, anemia in patients are improved. HP is especially useful.