两种常用血液透析方法治疗尿毒症皮肤瘙痒效果比较

EFFECT OF HEMODIALYSIS ON UREMIC PRURITIS:COMPARISON OF TWO COMMONLY USED

目的比较两种常用的血液透析方法对尿毒症病人皮肤瘙痒的治疗效果。方法 2009年1月—2010年1月,在我院治疗的典型尿毒症皮肤瘙痒病人30例,随机分为2组。对照组15例行普通血液透析,每周3次;观察组15例行血液透析滤过每周1次,血液透析每周2次,治疗12周。两组在治疗同时结合实施心理护理、皮肤对症护理、饮食护理和卫生宣教。治疗前后测定两组血清甲状旁腺素(PTH)水平。结果观察组病人治疗后血PTH水平明显下降(t=29.39,P<0.01),而对照组治疗后血PTH水平下降不明显(P>0.05)。结论血液透析滤过能有效地清除PTH,对治疗皮肤瘙痒效果更佳。护理干预对治疗皮肤瘙痒也起一定作用。

Objective To compare two commonly used hemodialytic methods in the treatment of pruritis in patients with uremia. Methods From Jan.2009 to Jan.2010,30 patients with typical uremic pruritis were treated in our hospital.The patients were evenly randomized to control group and observation group.For patients in the control group,ordinary hemodialysis was offered,3 times a week;for those in the observation group,hemodiafiltration was carried out,once a week,and hemodialysis,twice a week.The therapy in both groups lasted for 12 weeks.Mental nursing,symptomatic management,diet guidance,and health education were conducted at the same time.The serum level of PTH was detected before and after therapy. Results The serum level of PTH in observation group decreased significantly after therapy（t=29.39,P0.01）,while that in the control group did not significantly decrease（P0.01）. Conclusion Hemodiafiltration can effectively eliminate PTH,which is better in the treatment of itch of skin,and nursing care can also play a role in this aspect.