血液灌流联合血液透析治疗尿毒症期患者皮肤瘙痒的疗效分析

Analysis of the Effect of Hemoperfusion Combined with Hemodialysis in the Treatment of Pruritus in Patients with Uremia

目的分析血液灌流联合血液透析治疗尿毒症皮肤瘙痒的疗效。方法方便选择2018年3月—2020年3月该院尿毒症皮肤瘙痒患者共64例,数字表随机分两组,每组32例。对照组的患者给予血液透析治疗,观察组在该治疗基础上增加血液灌流。比较两组治疗前后患者尿素氮水平、肌酐水平、甲状旁腺素水平以及β2-微量白蛋白水平、皮肤瘙痒的评分表、总有效率、不良反应。结果治疗后观察组尿素氮水平、肌酐水平、甲状旁腺素水平以及β2-微量白蛋白水平分别是(23.56±1.21)mmol/L、(712.19±3.42)μmol/L、(312.56±13.21)ng/dl、(12.19±2.32)mg/L,低于对照组的(25.12±1.67)mmol/L、(812.21±5.35)μmol/L、(485.56±45.88)ng/dl、(18.19±2.78)mg/L,皮肤瘙痒的评分表分数(0.56±0.12)分显著低于对照组(1.34±0.24)分,差异有统计学意义(t=4.279、89.106、20.498、9.374、16.444,P<0.05)。观察组总有效率(96.88%)高于对照组(75.00%),差异有统计学意义(χ^(2)=4.655,P<0.05)。两组治疗过程不良反应未见,差异无统计学意义(P﹥0.05)。结论血液透析联合血液灌流对于尿毒症皮肤瘙痒的治疗效果确切,可有效降低甲状旁腺素水平,缓解皮肤瘙痒。

Objective To analyze the efficacy of hemoperfusion combined with hemodialysis in the treatment of uremia skin itching.Methods A total of 64 patients with pruritus uremia in the hospital from March 2018 to March 2020 were conveniently selected.The number table was randomly divided into two groups with 32 patients in each group.The patients in the control group were given hemodialysis treatment,and the observation group increased hemoperfusion on the basis of this treatment.The urea nitrogen levels,creatinine levels,parathyroid hormone levels,β2-microalbumin levels,skin pruritus scores,total effective rates,and adverse reactions were compared between the two groups before and after treatment.Results After treatment the levels of urea nitrogen,creatinine,parathyroid hormone andβ2-microalbumin in the observation group were(23.56±1.21)mmol/L,(712.19±3.42)μmol/L,(312.56±13.21)ng/dl,(12.19±2.32)mg/L,lower than the control group(25.12±1.67)mmol/L,(812.21±5.35)μmol/L,(485.56±45.88)ng/dl,(18.19±2.78)mg/L,the score of skin pruritus(0.56±0.12)points was significantly lower than that of the control group(1.34±0.24)points,and the difference was statistically significant(t=4.279,89.106,20.498,9.374,16.444,P<0.05).The total effective rate of the observation group(96.88%)was higher than that of the control group(75.00%),and the difference was statistically significant(χ^(2)=4.655,P<0.05).There were no adverse reactions in the treatment process between the two groups,and the difference was not statistically significant(P>0.05).Conclusion Hemodialysis combined with hemoperfusion has a definite therapeutic effect on uremia skin pruritus,which can effectively reduce the level of parathyroid hormone and relieve skin pruritus.