不同透析方式治疗老年终末期肾病的临床效果分析

Analysis of the clinical effects of different dialysis methods in the treatment of elderly end-stage renal disease

目的探讨不同透析方式治疗老年终末期肾病(ESRD)的临床效果。方法96例老年ESRD患者,根据透析方式的不同分为对照组及研究组,每组48例。对照组采用腹膜透析治疗,研究组采用腹膜透析联合血液透析治疗。比较两组患者治疗前后的生化指标[血红蛋白(Hb)、血钾(K^(+))、血磷(P)、血肌酐(Scr)、血清白蛋白(ALB)、甲状旁腺激素(PTH)]及免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平,并发症发生情况。结果治疗后,两组患者的Hb、ALB水平均较治疗前升高,K^(+)、P、Scr、PTH水平均较治疗前降低,且研究组患者的Hb(105.42±18.33)g/L、ALB(36.37±7.36)g/L高于对照组的(85.71±12.64)、(29.41±6.14)g/L,PTH(423.67±32.62)ng/L低于对照组的(558.21±34.82)ng/L,差异具有统计学意义(P<0.05)。治疗后,两组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前升高,CD8^(+)水平均较治疗前降低,且研究组患者的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组,差异具有统计学意义(P<0.05)。研究组并发症发生率12.50%低于对照组的29.17%,差异具有统计学意义(P<0.05)。结论相较于腹膜透析单一治疗,腹膜透析联合血液透析应用于老年ESRD患者的治疗中,可以明显改善其生化指标,提升免疫功能,降低并发症发生率,值得推广应用。

Objective To discuss the clinical effect of different dialysis methods in the treatment of elderly end-stage renal disease(ESRD).Methods A total of 96 elderly patients with ESRD were divided into control group and research group according to different dialysis methods,with 48 cases in each group.The control group was treated with peritoneal dialysis,while the research group was treated with peritoneal dialysis combined with hemodialysis.Both groups were compared in terms of biochemical indexes[hemoglobin(Hb),serum potassium(K^(+)),serum phosphorus(P),serum creatinine(Scr),serum albumin(ALB),parathyroid hormone(PTH)]and immune functional indicators(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),and complications.Results After treatment,the Hb and ALB in the two groups were higher than those of this group before treatment,and the K^(+),P,Scr and PTH were lower than those of this group before treatment;the Hb(105.42±18.33)g/L and ALB(36.37±7.36)g/L in the research group were and higher than(85.71±12.64)and(29.41±6.14)g/L in the control group,and the PTH(423.67±32.62)ng/L was lower than(558.21±34.82)ng/L in the control group;all the differences were statistically significant(P<0.05).After treatment,the CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the two groups were higher than those before treatment in this group,and the CD8^(+)was lower than that before treatment in this group;the CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the research group were higher than those in the control group,and the CD8^(+)was lower than that in the control group;all the differences were statistically significant(P<0.05).The complication rate in the research group was 12.50%,which was lower than 29.17% in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with peritoneal dialysis monotherapy,peritoneal dialysis combined with hemodialysis in the treatment of elderly patients with end-stage renal disease can significantly improve their biochemical indexes,enhance immune function,and reduce the occurrence of complications.It is worthy of popularization and application.