血液灌流联合血液透析治疗尿毒症的疗效及对患者肾功能的影响

Curative Effect of Hemoperfusion Combined with Hemodialysis in the Treatment of Uremia and Influence on Patients' Renal Function

目的探讨血液灌流联合血液透析治疗尿毒症的疗效及对患者肾功能的影响。方法选取我院2015年6月至2016年12月收治的80例尿毒症患者,随机分为两组各40例。对照组采用血液透析治疗,观察组采用血液灌流联合血液透析治疗。对比两组患者治疗前后的血液毒性物质和残存肾功能情况。结果治疗后,观察组的BUN、Ca^(2+)和PTH水平分别为(10.41±3.49)mmol/L、(1.74±0.33)mmol/L和(165.32±71.07)ng/L,均显著低于对照组的(15.68±3.84)mmol/L、(2.25±0.36)mmol/L和(241.56±75.16)ng/L,差异有统计学意义(P<0.05)。两组患者的Scr水平比较差异无统计学意义(P>0.05)。治疗后,观察组的血磷水平为(0.50±0.22)mmol/L,明显低于对照组的(0.88±0.37)mmol/L,差异有统计学意义(P<0.05)。治疗后,观察组的残存肾功能为(1.25±0.68)mL/min,显著高于对照组的(0.64±0.25)mL/min,差异有统计学意义(P<0.05)。结论血液灌流联合血液透析治疗尿毒症患者,可提高血液毒性物质的清除率,并保护残存肾功能,值得临床推广。

Objective To explore the curative effect of hemoperfusion combined with hemodialysis in the treatment of uremia and influence on patients＇ renal function. Methods 80 cases of patients with uremia admitted to our hospital from June 2015 to December 2016 were selected and randomly divided into two groups, with 40 cases in each group. The control group received hemodialysis, while the observation group received hemoperfusion combined with hemodialysis. The blood toxic substances and residual renal function before and after treatment were compared between two groups. Results After treatment, the BUN, Ca2± and PTH levels of observation group were respectively （10.41 ± 3.49） retool/L, （1.74 ± 0.33） mmol/L and （165.32 ± 71.07） ng/L, significantly lower than （15.68 ± 3.84） mmol/L, （2.25 ± 0.36） mmol/L and （241.56 ± 75.16） ng/L of control group, with statistical differences （P〈0.05）. No statistical difference was found in the Scr level between two groups （P 〉0.05）. After treatment, the blood phosphorus level of observation group was （0.50 ± 0.22） mmol/L, significantly lower than （0.88 ± 0.37） mmol/L of control group, with statistical difference （P 〈0.05）. After treatment, the residual renal function of observation group was （1.25 ± 0.68） mL/min, significantly higher than （0.64 ± 0.25） mL/min of control group, with statistical difference （P 〈0.05）. Conclusions Hemoperfusion combined with hemodialysis in the treatment of patients with uremia, can improve the clearance rate of blood toxic substances and protect the residual renal function, which is worthy of clinical promotion.