血液透析患者神经系统并发症的相关因素分析及干预对策

Influencing factors and intervention strategies of complications of nervous system in patients with hemodialysis

目的探讨血液透析患者神经系统并发症的相关因素,并提出干预对策。方法选取血液透析患者4 103例,对其临床资料进行回顾分析。将出现神经系统并发症的211例患者随机分为对照组103例,观察组108例,对照组患者实施常规血液透析治疗,观察组实施血液灌流串联血液透析治疗,观察2组患者毒素水平以及临床症状。结果发生神经系统并发症的患者中高龄、并发糖尿病、治疗依从性较差,透析过程中出现毒素升高、离子和代谢紊乱、焦虑的患者所占比例明显高于无神经系统并发症的患者,差异有统计学意义(P<0.05)。观察组中分子物质(MSS)明显低于对照组,差异有统计学意义(P<0.05),但2组BUN、CR水平差别无统计学意义(P>0.05)。观察组患者临床症状较治疗前明显减少,2组比较差异有统计学意义(P<0.05)。结论血液透析患者发生神经系统并发症,主要受中分子和大分子毒素的影响,血液灌流串联血液透析为患者提供了一种良好的透析方法。

Objective To investigate influencing factors and intervention strategies of complications of nervous system in patients with hemodialysis.Methods 4 103 patients with hemodialysis were selected,clinical data were retrospectively analyzed;of which 211 patients with neurological complications were divided into two groups,103 patients in control group,and108 cases in observation group.Control group was treated with the conventional hemodialysis,and observation group was implemented hemoperfusion and hemodialysis treatment.Toxin levels and clinical symptoms in both groups were observed.Results The patients with neurological complications had advanced age,diabetes,and poor treatment compliance;toxins elevated during dialysis,ionic and metabolic disorders,anxiety were significantly higher than patients without neurological complications,the differences were significant（P〈0.05）.After treatment and intervention,the observation group was significantly lower than the control group on MSS,the difference was statistically significant（P〈0.05）,but BUN,CR levels in the two groups had no statistically significant difference（P〈0.05）.After treatment,the clinical symptoms in observation group were significantly reduced compared with that before treatment,the difference was statistically significant（P〈0.05）.ConclusionHemodialysis patient occurring neurological complications,mainly due to the effects of the toxin molecules and macromolecules;hemoperfusion for patients on hemodialysis provides a good dialysis method.