3种血液净化方式治疗慢性肾衰竭的临床疗效比较分析

Comparative Analysis of Clinical Efficacy of Three Blood Purification Methods in Treating Chronic Renal Failure

目的探讨3种血液净化方式治疗慢性肾衰竭的临床疗效对比。方法选取该院2018年3月—2019年3月期间收治的76例慢性肾衰竭患者,随机分为A组25例、B组25例、C组26例。3组均使用碳酸氢盐缓冲液、肝素抗凝,如果存在出血倾向可通过低分子肝素抗凝,连续治疗0.5年。A组接受血液吸附+血液透析方法治疗,B组接受血液透析滤过方法治疗,C组接受血液透析方法治疗。观察3组血清β2-微球蛋白、甲状腺旁腺素、全段甲状旁腺素iPTH水平。结果治疗后,A组血清β2-微球蛋白(11.4±2.4)mg/L、甲状腺旁腺素(110.5±31.1)ng/L明显优于B组的(18.2±2.9)mg/L、(146.2±32.6)ng/L和C组的(40.9±3.1)mg/L、(320.4±32.8)ng/L,且A组、B组治疗后明显优于A组治疗前的(44.8±3.5)mg/L、(324.3±40.5)ng/L,B组治疗前的(44.4±3.3)mg/L、(323.6±38.4)ng/L,差异有统计学意义(P<0.05);治疗后,A组iPTH水平(127.75±35.61)ng/L、B组(125.65±39.62)ng/L,明显优于C组(326.46±85.27)ng/L,差异有统计学意义(P<0.05)。结论不同血液净化方法对慢性肾衰竭患者治疗的效果有显著差异,建议采取血液吸附+血液透析方法治疗,从而降低患者的血清β2-微球蛋白、甲状腺旁腺素,以及iPTH水平,存在临床方面应用的价值。

Objective To explore the clinical efficacy comparison of three blood purification methods in treating chronic renal failure.Methods 76 patients with chronic renal failure admitted to the hospital from March 2018 to March 2019 were randomly divided into 25 cases in group A,25 cases in group B,and 26 cases in group C.The three groups all used bicarbonate buffer and heparin for anticoagulation.If there is bleeding tendency,low molecular weight heparin can be used for anticoagulation for 0.5 years.Group A received hemodialysis+hemodialysis,group B received hemodiafiltration,and group C received hemodialysis.Observe the levels of serumβ2-microglobulin,parathyroid hormone,and whole parathyroid hormone iPTH in the three groups.Results After treatment,serumβ2-microglobulin(11.4±2.4)mg/L and parathyroid hormone(110.5±31.1)ng/L in group A were significantly better than(18.2±2.9)mg/L,(146.2±32.6)ng/L in group B and(40.9±3.1)mg/L,(320.4±32.8)ng/L in group C,and after treatment,groups A and B were significantly better than(44.8±3.5)mg/L,(324.3±40.5)ng/L before treatment in group A,(44.4±3.3)mg/L,(323.6±38.4)ng/L before treatment in group B,and the difference was statistically significant(P<0.05);after treatment The iPTH level in group A was(127.75±35.61)ng/L,group B was(125.65±39.62)ng/L,which was significantly better than group C group(326.46±85.27)ng/L,and the difference was statistically significant(P<0.05).Conclusion Different blood purification methods have significant differences in the treatment of patients with chronic renal failure.It is recommended to use blood adsorption+hemodialysis to reduce the serumβ2-microglobulin,parathyroid hormone,and iPTH levels in patients.The value of application.