血液透析联合血液灌流对维持性血液透析患者的临床疗效观察

Clinical observation of hemodialysis combined with hemoperfusion in patients with maintenance hemodialysis

目的分析血液透析联合血液灌流在维持性血液透析患者中的应用价值。方法以新疆医科大学第一附属医院血液透析科2020年3月-2021年3月收治的90例维持性血液透析患者为研究对象,根据住院顺序按随机数字表法分为观察组和对照组,每组45例。对照组采用血液透析治疗,观察组采用血液透析联合血液灌流治疗。治疗3个月后,观察两组的临床疗效,比较两组治疗前及治疗3个月后匹兹堡睡眠质量指数(PSQI)、Duo氏改良瘙痒评分量表(Duo氏)评分、简明健康状况量表(SF-36)评分、全段甲状旁腺激素(iPTH)、β2-微球蛋白(β2-MG)、血磷(P)、血钙(Ca)水平。结果观察组治疗总有效率(97.78%)较对照组(71.11%)高,差异有统计学意义(P<0.05);与对照组比较,观察组治疗后睡眠障碍、催眠药物、睡眠质量、日间功能障碍、入睡时间、睡眠时间评分和睡眠质量总分均显著下降,差异均有统计学意义(P均<0.05);与对照组比较,观察组治疗后Duo氏评分降低,SF-36评分升高,差异均有统计学意义(P均<0.05);与对照组比较,观察组治疗后iPTH、β2-MG、P水平均降低,Ca水平升高,差异均有统计学意义(P均<0.05)。结论血液透析联合血液灌流能明显改善维持性血液透析患者睡眠质量及生活质量,值得临床推广。

Objective To explore the application value of hemodialysis combined with hemoperfusion in maintenance he⁃modialysis.Methods Ninety maintenance hemodialysis patients admitted to the hemodialysis room of the hospital from March 2020 to March 2021 were taken as the research objects.The patients were randomly divided into the observa⁃tion group and the control group with random number table method according to the order of hospitalization,with 45 cases in each group.The control group was treated with hemodialysis,and the observation group was treated with hemo⁃dialysis combined with hemoperfusion.After 3 months of treatment,the clinical effects of the two groups were analyzed and compared.The sleep quality scores,skin pruritus(Duo)score,quality of life(SF-36)scores,total parathyroid hor⁃mone(iPTH),β2-microglobulin(β2-MG),blood phosphorus(P),and blood calcium were compared between the two groups before the treatment and after 3 months of the treatment.Results The total effective rate of the observation group(97.78%)was higher than that of the control group(71.11%);compared with the control group,the sleep distur⁃bance,sleep efficiency,hypnotic drugs,sleep quality,daytime dysfunction,time to fall asleep,sleep time score,and to⁃tal sleep quality scores in the obseration group were increased after the treatment,and the difference was statistically significant(P<0.05);compared with the control group,the Duo score of the observation group was decreased after the treatment,and the SF-36 score was increased,the difference was statistically significant(P<0.05);compared with the control group,iPTH,β2-MG and P levels of the observation group after the treatment were decreased,and the Ca level was increased,and the difference was statistically significant(P<0.05).Conclusion Hemodialysis combined with he⁃moperfusion can improve patients′sleep quality and quality of life,which is worthy of clinical promotion.