尿毒症采用血液灌流联合血液透析方案治疗的效果与肾功能指标分析

Analysis of the Effect of Hemoperfusion Combined with Hemodialysis in the Treatment of Uremia and Renal Function Indexes

目的探讨尿毒症患者采用血液灌流联合血液透析方案治疗的效果及对肾功能指标的影响。方法选取2020年1—12月该院收治的尿毒症共80例患者为研究对象,依据随机数表法划分成对照组(仅予以血透治疗)和研究组(除对照组治疗之外加以血液灌流)各40例,比较两组治疗后有效率、治疗前后血尿酸(UA)、血肌酐(Scr)、尿素氮(BUN)、血磷(P)、血钙(Ca)、钙磷乘积及甲状旁腺素(iPTH)水平。结果研究组治疗有效率95.00%比对照组80.00%更高,差异有统计学意义(χ^(2)=4.114,P<0.05);治疗前,两组BUN、Scr及UA水平对比差异无统计学意义(P>0.05);治疗后,研究组BUN、Scr及UA水平分别为(12.20±2.64)mmol/L、(362.50±102.85)μmol/L、(258.74±79.65)μmol/L比对照组更低,差异有统计学意义(t=3.449、2.006、2.020,P<0.05);治疗前,两组iPTH、P、Ca及钙磷乘积水平对比差异无统计学意义(P>0.05);治疗后,研究组iPTH、P及钙磷乘积水平比对照组更低,差异有统计学意义(P<0.05),两组Ca水平对比差异无统计学意义(P>0.05);研究组不良反应总发生率与对照组对比差异无统计学意义(P>0.05)。结论血液透析加血液灌流对尿毒症疗效确切,能改善患者的钙磷代谢、肾功能及iPTH水平,且无严重不良反应发生,安全可行,值得采用。

Objective To investigate the effect of hemoperfusion combined with hemodialysis in the treatment of uremia patients and the effect on renal function indexes.Methods Selected 80 patients with uremia who were treated in the hospital from January to December 2020 as the research objects.According to the random number table method,they were divided into the control group(with hemodialysis only)and the study group(with blood perfusion in addition to the control group).There were 40 cases in the group.The effective rate after treatment,serum uric acid(UA),serum creatinine(Scr),blood urea nitrogen(BUN),serum phosphorus(P),serum calcium(Ca),calcium-phosphorus product and parathyroid hormone(iPTH)levels before and after treatment were compared between the two groups.Results The treatment effective rate in the study group was 95.00%higher than that in the control group(80.00%),the difference was statistically significant(χ^(2)=4.114,P<0.05).Before treatment,there was no statistically significant difference in the levels of BUN,Scr and UA between the two groups(P>0.05).After treatment,the levels of BUN,Scr and UA in the study group were(12.20±2.64)mmol/L,(362.50±102.85)μmol/L,and(258.74±79.65)μmol/L,respectively,which were lower than those in the control group,the difference was statistically significant(t=3.449,2.006,2.020,P<0.05);before treatment,there was no statistically significant difference in the levels of iPTH,P,Ca and calcium-phosphorus product between the two groups(P>0.05);after treatment,the iPTH,P and calcium-phosphorus product levels in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05),there was no statistically significant difference in Ca levels between the two groups(P>0.05),and there was no statistically significant difference in the total incidence of adverse reactions between the study group and the control group(P>0.05).Conclusion Hemodialysis plus hemoperfusion is effective in the treatment of uremia,can improve calcium and phosphorus metabolism,renal function and iPTH level,and has no serious adverse reactions.It is safe and feasible,and worthy of application.