血液灌流联合血液透析与血液透析滤过治疗老年慢性肾功能不全的疗效分析

Curative effect of hemoperfusion plus hemodialysis and hemodiafiltration in the treatment of elderly chronic renal insufficiency

目的分析血液灌流(hemoperfusion,HP)联合血液透析(hemodialysis,HD)与血液透析滤过(hemodiafiltration,HDF)治疗老年慢性肾功能不全的疗效差异。方法选取成飞医院2018年1月至2020年1月收治的200例老年慢性肾功能不全患者,按照随机数字表法分为两组各100例,HDF组采取HDF治疗,HP+HD组采取HP+HD治疗,6个月后比较两组氧化应激水平、炎症反应水平、肾功能、睡眠质量、生存质量、并发症发生率。结果治疗前两组氧化应激水平、炎症反应水平、肾功能指标、睡眠质量评分、生存质量评分差异无统计学意义(P>0.05),治疗6个月后均较治疗前显著改善,差异有统计学意义(P<0.05),HP+HD组氧化应激水平、炎症反应水平、肾功能指标、睡眠质量评分、生存质量评分与HDF组相比较,差异无统计学意义(P>0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论在老年慢性肾功能不全治疗中HP联合HD与HDF取得的疗效相当,均有助于抑制氧化应激反应及炎症反应,改善肾功能及患者预后,提高睡眠质量,临床可根据患者情况合理选用。

Objective To explore the difference in curative effect between hemoperfusion(HP)plus hemodialysis(HD)and hemodiafiltration(HDF)in the treatment of elderly chronic renal insufficiency.Methods From January 2018 to January 2020,200 elderly in patients with chronic renal insufficiency were selected and divided into two groups in accordance with a random number table(n=100 each).HDF group was subjected to HDF and HP+HD group HP plus HD.After 6-month treatment,two groups were compared with regards to oxidative stress level,inflammatory response level,renal function,sleep quality,quality-of-life and incidence of complications.Results No significant inter-group difference existed in oxidative stress level,inflammatory response level,renal function index,sleep quality score or quality-of-life score pre-treatment(P>0.05).After 6-month treatment,they were significant improvements as compared to pre-treatment.There were statistically significant differences(P<0.05).However,as compared with HDF group,oxidative stress level,inflammatory response level,renal function index,sleep quality score and quality-of-life score HP+HD group showed no statistically significant difference(P>0.05);The complication rate was the same and the difference was not statistically significant(P>0.05).Conclusion For elderly chronic renal insufficiency,HP+HD and HDF have the comparable curative effect.It may help to suppress oxidative stress and inflammation,improve renal function and patient prognosis and improve sleep quality.A proper selection is made in light of actual patient situations.