两种不同透析方式对维持性血液透析患者临床疗效的观察

The Clinical Observation of Maintenance Hemodialysis Patients with Different Dialysis Modes

目的:探究普通血液透析及联合血液灌流治疗维持性血液透析患者时在临床疗效方面存在的差异。方法:选取2017年7月—2018年7月我院血液净化中心收治的规律性透析治疗患者142例为研究对象,其中血液透析组(HD组)患者共82例,而血液透析联合血流灌注组(HD+HP组)患者共60例。分别对两组患者的钙磷代谢、透析充分性、营养状况、贫血等方面进行评价,比较两者对维持性血液透析患者临床疗效的差异。结果:经过1年的规律治疗后,HD+HP组钙磷代谢紊乱、贫血、Kt/V的改善幅度优于HD组,而白蛋白显著高于HD组,β_2-MG显著低于HD组,差异具有统计学意义(P <0. 05)。结论:血液灌流联合血液透析治疗相比单纯血液透析更具有优势,主要体现在以下方面:(1)具有更高的透析充分性,清除β_2微球蛋白等尿毒素分子更加彻底;(2)更好地改善机体的贫血状态和营养状况;(3)纠正钙磷代谢紊乱,延缓继发性甲状旁腺亢进进展。

Objective:To investigate the differences in clinical efficacy between general hemodialysis and combined blood perfusion in the treatment of maintenance hemodialysis(MHD)patients.Methods:A total of 142 patients with maintenance dialysis treatment admitted to the Blood Purification Center of Gaozhou People's Hospital from July 2017 to July 2018 were enrolled.Among them,there were 82 patients in the hemodialysis group(HD group),a total of 60 patients in the hemodialysis combined blood perfusion group(HD+HP group).The calcium and phosphorus metabolism,dialysis adequacy,nutritional status,and anemia were evaluated in the two groups,and the clinical efficacy of the two groups in maintenance hemodialysis patients were compared to select a more appropriate way to guide clinical treatment.Results:After one year of maintenance hemodialysis treatment,the improvement of calcium and phosphorus metabolism,anemia and Kt/V in HD+HP group was better than that in HD group,and albumin was significantly higher than that in HD group,β2-microglobulin was significant.The difference was statistically significant(P<0.05).Conclusion:Hemodialysis combined with blood perfusion treatment has advantages over hemodialysis alone,mainly in the following aspects:(1)with higher dialysis adequacy,more thorough elimination ofβ2 microglobulin and other urinary toxin molecules;(2)to improve the body's anemia and nutritional status;(3)to correct calcium and phosphorus metabolism disorders,delay the progression of secondary hyperparathyroidism.