血液透析联合腹膜透析治疗终末期肾病的临床效果

Clinical Effect of Hemo Dialysis Combined with Peritoneal Dialysis in the Treatment of End-stage Renal Disease

目的:探讨血液透析(HD)联合腹膜透析(PD)治疗终末期肾病(ESRD)的临床效果。方法:选取2015年3月-2017年3月本院收治的84例ESRD患者作为研究对象,按照随机数字表法将其分为观察组与对照组,各42例。对照组行PD治疗,观察组在对照组基础上联合HD治疗。比较两组治疗前及治疗6个月后血液生化、电解质及营养指标变化,并对两组尿素清除指数(Kt/V)、肌酐清除率(Ccr)和达标率及并发症进行分析。结果:治疗6个月后,两组血清肌酐(Scr)、尿素氮(BUN)、甲状旁腺激素(PTH)、β2-微球蛋白(β2-MG)、血磷(IP)与钾(K)均低于治疗前,血清白蛋白(ALB)、血红蛋白(Hb)均高于治疗前,差异均有统计学意义(P<0.05);治疗6个月后,观察组BUN、PTH、血β2-MG水平均低于对照组,ALB、Hb均高于对照组,差异均有统计学意义(P<0.05),但两组Scr、IP与K比较,差异均无统计学意义(P>0.05)。观察组平均总Kt/V和平均每周总Ccr值及达标率均高于对照组,并发症发生率低于对照组,差异均有统计学意义(P<0.05)。结论:PD联合HD治疗ESRD的效果较好,可纠正代谢紊乱,降低单一应用PD或HD透析不充分所导致的并发症多等风险。

Objective:To explore the clinical effect of hemo dialysis (HD) combined with peritoneal dialysis (PD) in the treatment of end-stage renal disease (ESRD).Method:A total of 84 ESRD patients admitted to our hospital from March 2015 to March 2017 were selected as research objects,according to the random number table,they were divided into observation group and control group,42 cases in each group.PD was used in the control group,HD was used in the observation group on the basis of the control group.The changes of blood biochemical,electrolyte and nutritional indexes before and 6 months after treatment were compared between the two groups,the urea clearance index (Kt/V),creatinine clearance rate (Ccr),the rate of reaching the standard and complications were analyzed betwwen the two groups.Result:After 6 months of treatment,the concentrations of serum creatinine (Scr),urea nitrogen (BUN),parathyroid hormone (PTH),β2-microglobulin (β2-MG),serum phosphorus (IP) and potassium (K) in the two groups were lower than those before treatment,and serum albumin (ALB) and hemoglobin (Hb) were higher than those before treatment,the differences were statistically significant (P<0.05);after 6 months treatment,the levels of BUN,PTH and β2-MG in the observation group were lower than those in the control group,ALB and Hb were higher than those in the control group,the differences were statistically significant (P<0.05),but there were no significant differences in the concentrations of Scr,IP and K between the two groups (P>0.05).The average total Kt/V,average weekly Ccr and the rate of reaching the standard in the observation group were higher than those in the control group,and the incidence of complications was lower than that in the control group,the differences were statistically significant (P<0.05).Conclusion:PD combined with HD is effective in treating ESRD,which can correct metabolic disorder and reduce the risk of complications caused by PD alone or HD inadequate dialysis.