高通量血液透析对血透患者甲状旁腺素的影响及护理体会

Effect of high-flux hemodialysis on parathyroid hormone and the nursing experience

目的:探讨高通量血液透析(HFHD)对血透患者血清甲状旁腺素(PTH)的影响,讨论护理特点。方法:选择40例慢性肾衰维持性血液透析患者,随机分为HFHD组、普通血液透析(HD)组各20例,分别于单次透析前、后测定患者血清尿素氮(BUN)、肌酐(Cr)、钙(Ca)、磷(P)和PTH水平。结果:HD和HFHD治疗对血BUN、Cr、Ca的清除率差异无统计学意义(P>0.05)。HFHD对血P和PTH的清除率明显高于HD(P<0.05)。结论:HFHD能有效降低血PTH浓度。透析护理过程中,必须加强观察并重视患者的不适主诉;对于超滤量少的患者,可在适当补充液体的同时增加超滤量,以提高跨膜压,防止反超。

Objective：To investigate the effect of high-flux hemodialysis（HFHD） on parathyroid hormone（PTH）,and explore the care characteristics.Methods：forty patients with maintain hemodialysis were randomly divided into two groups：HFHD group and low flux maintenance hemodialysis（HD） group.Blood urea nitrogen（BUN）,creatinine（Cr）,calcium（Ca）,phosphorus（P） and PTH were measured before and after these treatments.Results：There was no significant difference between HD and HFHD in the clearance rate of BUN,Cr and Ca（P 0.05）,but the clearance rate of P and PTH of HFHD were superior to that of HD（P 0.05）.Conclusion：HFHD can decrease PTH level.Great importance should be attached to the complaints from patients during dialysis.For those with less ultrafiltration,fluid as well as ultrafiltration should be supplemented to increase the transmembrane pressure.