不同血液净化方式的透析效果及对患者营养状态的影响研究

Effects of different blood purification methods on the nutritional status of hemodialysis

目的分析不同血液净化方式的透析效果及对患者营养状态的影响。方法将本院2012年4月至2014年12月收治的79例维持性血液透析患者根据治疗方式不同分为常规组(单纯血液透析治疗,39例)和联合组(血液透析联合血液透析滤过治疗,40例),两组患者均规律治疗6个月。对比两组患者透析前后血尿素氮(BUN)、血肌酐(Scr)、血钙、尿素清除指数(Kt/V)、血磷及部分营养学指标的差异。结果透析后联合组患者BUN、血磷、甲状旁腺激素(PTH)水平均低于常规组(P<0.05),Kt/V、血清总蛋白(TP)、清蛋白(ALB)、血红蛋白(Hb)水平均显著高于常规组(P<0.05)。两组患者透析前后总胆固醇(TC)、三酰甘油(TG)水平组间、组内比较差异均无显著性(P>0.05)。透析后联合组患者营养不良-炎症评分(MIS)显著低于常规组(P<0.05)。结论血液透析联合血液透析滤过对维持性血液透析患者透析效果较好,且有利于改善患者营养状态。

Objective To analyze the effect of different blood purification methods on the nutritional status and the effect of hemodialysis. Method 79 patients admitted to our hospital with maintenance hemodialysis treatment from April 2012 to December 2014 were divided into routine group（simple hemodialysis treatment, 39 cases） and combined group（hemodialysis plus hemodiafiltration therapy, 40 cases） according to the different treatment methods, two groups of patients were treated with regular treatment for 6 months. BUN, Scr, blood calcium, Kt/V, serum phosphorus and some nutritional indexes were compared between the two groups before and after dialysis. Result After dialysis, the levels of PTH, serum phosphorus and BUN of combined group were lower than conventional group（P〈0.05）, and Kt/V, the levels of TP, ALB and Hb were significantly higher than conventional group（P〈0.05）. There were no significant differences in the levels of TG and TC between the two groups before and after dialysis（P〉0.05）. After dialysis, the MIS score of combined group was significantly lower than conventional group（P〈0.05）. Conclusion The effect of hemodialysis combined with hemodialysis on filtration maintenance hemodialysis patients is better, and it is beneficial to improve the nutritional status of patients.