血液灌流串联血液透析治疗尿毒症顽固性皮肤瘙痒的临床观察

Clinical comparative analysis of using hemoperfusion and hemodialysis in series in treating refractory uremic pruritus

目的观察血液灌流串联血液透析治疗尿毒症顽固性皮肤瘙痒的疗效。方法将56例尿毒症顽固性皮肤瘙痒患者随机分为两组,观察组接受血液灌流串联血液透析治疗,对照组采用常规血液透析治疗。使用改良Duo氏瘙痒评分法观察两组患者治疗前后2周、4周、8周皮肤瘙痒积分,以及血PTH、β2-MG的变化与不良反应。结果治疗8周后,观察组患者皮肤瘙痒明显好转,Duo积分显著降低,完全缓解率为53.6%(15/28),部分缓解率为28.5%(8/28),总有效率82.1%(23/28);对照组的完全缓解率为14.3%(4/28),部分缓解率为25.0%(7/28),总有效率39.3%(11/28)。两组比较差异有统计学意义(P<0.01)。结论血液灌流串联血液透析能有效治疗尿毒症患者顽固性皮肤瘙痒。

Objective To observe the effect of using hemoperfusion and hemodialysis in series for treating refractory uremic pruritus.Methods 56 patients with refractory uremic pruritus were randomly divided into two groups,the observation group（n=28）received hemodialysis and hemoperfusion in series,the control group（n=28）received conventional hemodialysis.Improved Duo′s pruritus score was used to observe skin itching points on 2,4,8 weeks before and after treatment,and also detect serum PTH,β2-MG changes and adverse reactions in the same time points.Results After 8 weeks,pruritus of patients in the observation group were significantly improved,Duo integral decreased notably,complete remission rate was 53.6%（15/28）,partial remission rate was 28.5%（8/28）,the total effective rate was 82.1%（23/28）;complete remission rate of the control group was 14.3%（4/28）,partial remission rate was 25.0%（7/28）,the total effective rate was 39.3%（11/28）.The difference was statistically significant（P0.01）.Conclusion Hemoperfusion and hemodialysis in series is effective in treating refractory uremic pruritus