血液透析滤过联合血液灌流治疗尿毒症脑病的疗效

The effect of hemodialysis filtration combined with blood perfusion in the treatment of patients with uremic encephalopathy

目的探讨血液透析滤过与血液灌流联用用于尿毒症脑病的疗效。方法选取30例尿毒症脑病患者，进行血液透析滤过与血液灌流联用治疗，治疗结束后观察其临床效果以及相关指标变化。结果在治疗时，1例患者昏迷5d，经过2次联合治疗后死亡；1例患者昏迷7d，经过3次联合治疗之后未恢复神志清醒；12例患者进行联合治疗1次后症状完全消失；剩余患者进行3次治疗之后症状有所减轻。神志转清患者为25例（83．3％）。治疗前患者BUN为（28．4±3．1）mmol／L，Scr为（749±99．6）mol／L，PTH为（245．7±35．2）Pg／g，K＋为（4．7±1．4）mmol／L，Na＋为（137．7±18．4）mmol/L，Cl-为（90．8±16．7）mmol／L，p2-MG为（25。4±3．4）mg／L。治疗后患者BUN为（9．1±2．4）mmol／L，Scr为（199．7±99．2）μmol／L，PTH为（105．64-33．6）Pg／g，K＋为（4．3±1．3）mmol／L，Na＋为（135．7±14．8）mmol／L，Cl-为（85．0±5．2）mmol／L，B2一MG为（13．4±3．1）mg／L。上述指标治疗前后差异均有统计学意义（均P〈0．05）。结论在治疗尿毒症脑病时，采用血液透析滤过与血液灌流联用的方法对血液清除率的提高效果明显，应在临床推广使用。

Objective To explore the effect of hemodialysis filtration and blood perfusion in the treatment of patients with uremic eneephalopathy. Methods 30 patients with uremic eneephalopathy were selected, they were treated with hemodialysis filtration and blood perfusion. After the treatment, the treatment effect and postoperative recovery of patients were compared. Results In the treatment, 1 case coma for 5 days, after 2 times treatment with death; 1 case coma for 7 days. After 3 times the combined treatment did not restore sanity; 12 patients of combined treatment after 1 time of the symptoms disappeared completely ; After 3 times of treatment on the patients with residual symptoms have less. Consciousness of patients was 25 cases （ 83. 3% ）. Before treatment, BUN was （ 28. 4 ± 3.1 ） mmoL/L, Set was （749 ±99.6） mol/L, PTH was （245.7 ± 35.2 ） pg/g, K＋ was （4, 7 ± 1.4） mmol/L, Na＋ was （ 137.7 ±18.4） mmol/L, Cl - was （90.8 ± 16.7 ） mmol/L, 132 - MG was （25.4 ±3.4 ） mg/L. After treatment, BUN was （9.1 ± 2.4） mmol/L, Ser was （ 199.7 ± 99.2） μmol/L, PTH was （ 105.6 ± 33.6） pg/g, K＋ was （4. 3 ±1.3）mmol/L,Na＋ was （135.7 ±14.8）mmol/L,C1- was （85.0 ±5.2）mmol/L,β2 -MG was （13.4±3.1） mg/L. The differences were statistically significant （ all P 〈 0.05 ）. Conclusion In the treatment of patients with uremic encephalopathy, hemodialysis filtration and blood perfusion have good effect, should be used in clinical promotion.