低钙透析联合血液灌流治疗维持性血液透析继发性甲状旁腺功能亢进的疗效分析

Efficacy Analysis of Low Calcium Dialysis Combined with Hemoperfusion in Treatment of Secondary Hyperparathyroidism in Maintenance Hemodialysis

目的:研究低钙透析联合血液灌流疗法对继发性甲状旁腺功能亢进患者的应用效果。方法:选取2019年2月-2021年10月湖北省宜昌市远安县人民医院接收的82例继发性甲状旁腺功能亢进患者作为研究对象,利用随机抽样法将患者分为两组,各41例。常规组患者在骨化醇冲击治疗基础上采用血液透析进行治疗,研究组在骨化醇冲击治疗基础上采用低钙透析联合血液灌流进行治疗。观察患者治疗效果(包括脂代谢指标、甲状旁腺激素、血磷、血钙和钙磷乘积水平)。结果:治疗后,研究组脂代谢指标优于常规组,差异有统计学意义(P<0.05);治疗后,研究组甲状旁腺激素、血钙、血磷、钙磷乘积低于常规组,差异具有统计学意义(P<0.05)。结论:为继发性甲状旁腺功能亢进患者使用低钙透析加血液灌流共同治疗,可以改善患者脂代谢指标,能够有效改善患者血钙、血磷指标,临床应用价值较高。

Objective:To study the application effect of low calcium dialysis combined with hemoperfusion therapy in patients with secondary hyperparathyroidism.Methods:A total of 82 patients with secondary hyperparathyroidism received by the Yuanan County People's Hospital of Yichang City from February 2019 to October 2021 were selected as the study subjects.According to the random sampling method,the patients were randomly divided into two groups,with 41 cases in each group.The patients in the routine group were treated with hemodialysis on the basis of calcitriol pulse therapy,while the study group was treated with low calcium dialysis combined with hemoperfusion on the basis of calcitriol pulse therapy.The therapeutic effect of the patients(including lipid metabolism indexes,parathyroid hormone,serum phosphorus,serum calcium and calcium-phosphorus product levels)were observed.Results:After treatment,the lipid metabolism indexes in the study group were better than those in the routine group,and the difference was statistically significant(P<0.05).After treatment,the parathyroid hormone,blood calcium,blood phosphorus,calcium and phosphorus product in the study group were lower than those in the routine group,and the difference was statistically significant(P<0.05).Conclusion:The combined treatment of low calcium dialysis and hemoperfusion for patients with secondary hyperparathyroidism can improve the lipid metabolism indexes of patients,effectively improve the indexes of blood calcium and blood phosphorus,and has high clinical application value.