高位结肠透析治疗对改善老年慢性肾衰竭患者的临床症状观察

Clinical observation of elderly chronic renal failure treated by high-position colon dialysis

目的观察应用高位结肠透析联合中药保留灌肠治疗对老年慢性肾衰竭患者临床症状和血生化指标的影响,并探讨高位结肠透析的护理方法。方法随机选择60例老年慢性肾衰竭患者,采用高位结肠透析联合中药保留灌肠和肾脏病常规治疗。透析时间为12周,观察透析治疗前后患者恶心、呕吐、食欲减退、全身皮肤瘙痒、湿疹等临床症状及血肌酐、尿素、尿酸等生化指标的变化。结果应用结肠透析治疗12周后,60例患者中胃肠道症状的发生率由治疗前93.3%下降至8.3%,乏力症状的发生率由治疗前98.3%下降至21.7%,皮肤瘙痒症状的发生率由治疗前78.3%下降至20.0%,慢性湿疹症状有效缓解,差异均有统计学意义(P<0.05)。患者血清肌酐、尿素和尿酸值较治疗前显著降低分别为[(523.4±161.5vs451.2±149.5)μmmol/L,(25.0±6.5vs18.2±4.0)mmol/L,(463.0±89.9vs368.5±102.9)mmol/L],差异均有统计学意义(P<0.05)。结论高位结肠透析联合中药保留灌肠治疗可有效改善老年慢性肾衰竭患者的临床症状,并可在一定程度上降低血清肌酐、尿素和尿酸水平。

Objective To observe clinical efficiency of elderly chronic renal failure treated by high-position colon dialysis,and discuss the most appropriate nursing procesures. Methods Sixty elderly patients with chronic renal failure were divided into two groups randomly,each containing 30 cases. The patients in the observation group were treated with retention-enema with trigeminy viable organism via high-position colon dialysis,while others were treated with conventional therapy. To compare the improving on their simultaneous phenomenon of constipation（defecation interval,stool character,exertion effort and so on）and adverse effect. Results The therapeutic effect in the observation group is better than that in the control group and no obvious adverse effect. There were significant decrease in uremia incidence of symptom（nausea vomit before 93.3% vs after 8.3%,P〈0.05;debilitation before 98.3% vs after 21.7%,P〈0.05）.There was significant improvement in renal function〔Scr,before（ 523.4±161.5） vs after （451.2±149.5）,P0.01〕,blood urea nitrogen（25.0±6.5 vs 18.2±4.0）mmol/L,uric acid〔（463.0±89.9 vs 368.5±102.9 ）mmol/L,P〈0.05〕. Conclusion Retention-enema with trigeminy viable organism via high-position colon dialysis has a good effect on the habitual constipation in the elderly.