血液透析串联血液灌流治疗顽固性尿毒症性皮肤瘙痒

Hemoperfusion Connected with Hemodialysis in Treatment of Refractory Uremic Pruritus

目的:探讨血液透析串联血液灌流治疗顽固性尿毒症性皮肤瘙痒的应用价值。方法:选择尿毒症顽固性瘙痒患者63例,根据治疗方法的不同分为观察组和对照组,观察组患者采用血液灌流串联血液透析治疗,对照组患者选择常规血液透析治疗。结果:1.治疗后,对照组患者平均瘙痒评分分值为(20.43±3.47),较治疗前无明显变化(P>0.05),观察组患者平均瘙痒评分分值为(12.4±3.12),较治疗前显著降低,且显著低于对照组(P<0.05)。2.治疗后,两组患者MMS、BUN及Scr水平均显著低于治疗前,ALB水平均显著高于治疗前(P<0.05)。治疗后,观察组患者MMS水平显著低于对照组(P<0.05)。3.观察组中,随患者血P3-、β2-MG及PTH水平与患者瘙痒评分间均存在直线关系(P<0.05)。结论:血液透析串联血液灌流能够显著改善顽固性尿毒症性皮肤瘙痒的程度。

Objective：To investigate the value of Hemoperfusion connected with Hemodialysis in treatment of refractory uremic pruritus.Methods：63 cases of patients with refractory uremic pruritus were divided into two groups,the observation group were treated with Hemoperfusion connected with Hemodialysis,the control group patients choose conventional hemodialysis treatment.Results：1.After treatment,the itching rating score of the control group were（20.43±3.47）,there were no significant change compared with before（P0.05）.the itching rating score of the observation group were（12.4±3.12）,significantly lower than before treatment and the control group（P0.05）.2.After treatment,the average water of two groups of patients with MMS,BUN,and Scr significantly lower than before treatment,ALB,were significantly higher than before treatment（P0.05）.After treatment,observed patients MMS levels were significantly lower than the control group（P0.05）.3.there were linear relationship between the P3-、β2-MG and PTH levels and the pruritus score（P0.05）.Conclusion：hemodialysis connects with hemoperfusion can significantly improve the degree of refractory uremic pruritus.