骨化三醇联合血液灌流治疗继发性甲状旁腺功能亢进的探讨及护理体会

Study and Nursing Experience of Calcitriol and Blood Perfusion in Treatment of Secondary Hyperparathyroidism

目的探讨骨化三醇联合血液灌流治疗继发性甲状旁腺功能亢进的疗效及护理体会。方法选取2015年5月—2016年5月该院收治的60例维持性血液透析(MHD)患者,进行骨化三醇冲击联合血液灌流治疗,观察患者治疗前后全段甲状旁腺激素(i PTH)浓度、血钙、血磷、血红蛋白及其临床症状的变化情况。结果治疗前血清i PTH、Ca、P、Hb分别为(547.26±48.81)pg/m L、(1.73±0.27)mmol/L、(2.69±0.20)mmol/L、(8.53±1.34)g/d L,治疗后血清i PTH、Ca、P、Hb分别为(156.92±35.06)pg/m L、(2.40±0.25)mmol/L、(1.36±0.41)mmol/L、(10.13±1.07)g/d L,治疗前后患者各指标比较均差异有统计学意义(P<0.05)。患者治疗后,骨关节疼痛症状治疗总有效率为87.2%,皮肤瘙痒症状治疗总有效率为100.0%,患者的临床症状均有明显改善。结论骨化三醇联合血液灌流治疗能有效降低患者的继发性甲状旁腺功能亢进(SHPT),临床疗效好。

Objective To discuss the curative effect and nursing experience of calcitriol and blood perfusion in treat-ment of secondary hyperparathyroidism. Methods 60 cases of patients with MHD in our hospital from May 2015 to May 2016 were selected and treated with triol impulse and blood perfusion, and the changes of iPTH concentration, blood calcium and phosphorus and clinical symptoms of patients before and after treatment were observed. Results The differ-ences in the serum iPTH, Ca, P,Hb before and after treatment were statistically significant[（547.26±48.81）pg/mL,（1.73土 0.27）mmol/ L,（2.69±0.20）mmol/ L,（8.53±1.34）g/dL vs （156.92±35.06）pg/mL,（2.40±0.25）mmol/ L,（1.36±0.41）mmol/ L, （10.13±1.07）g / dL],（ P〈0.05）, after treatment, the total effective rate of bone joint pain symptoms and skin pruritus symptom was respectively 87.2% and 100.0%, and the clinical symptoms of patients were obviously improved. Conclu-sion The calcitriol and blood perfusion can effectively reduce the secondary hyperparathyroidism of patients and the clinical curative effect is better.