血液透析联合血液灌流方案治疗慢性肾衰竭临床观察

Clinical Observation of Hemodialysis Combined with Hemoperfusion in the Treatment of Chronic Renal Failure

目的探讨血液透析(HD)联合血液灌流(HP)方案治疗慢性肾衰竭(CRF)的临床疗效,以及对患者钙磷代谢的影响。方法选取医院2018年10月至2021年10月收治的CRF患者98例,按随机抽签法分为对照组和观察组,各49例。对照组患者给予HD方案,观察组患者给予HD+HP方案,均治疗12周。结果观察组总有效率为97.96%,显著高于对照组的83.67%(P<0.05);治疗后,观察组患者的肾功能指标[β_(2)-微球蛋白(β_(2)-MG)、血肌酐(SCr)、尿素氮(BUN)]、炎性因子[白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]及血磷水平均显著低于对照组(P<0.05),血钙水平显著高于对照组(P<0.05);观察组患者的不良反应发生率为4.08%,显著低于对照组的18.37%(P<0.05)。结论HD+HP方案治疗CRF的效果较好,可改善患者的肾功能与微炎性状态,维持钙磷代谢稳定,且安全性较高。

Objective To investigate the clinical efficacy of hemodialysis(HD)combined with hemoperfusion(HP)in the treatment of chronic renal failure(CRF),and its effect on calcium and phosphorus metabolism.Methods A total of 98 patients with CRF admitted to the hospital from October 2018 to October 2021 were selected and divided into the control group and the observation group by the the random drawing method,with 49 cases in each group.The patients in the control group were given HD regimen,while the patients in the observation group were given HD+HP regimen.Both groups were treated for 12 weeks.Results The total effective rate in the observation group was 97.96%,which was significantly higher than 83.67%in the control group(P<0.05).After treatment,the renal function indexes[β_(2)-microglobulin(β_(2)-MG),blood creatinine(SCr),urea nitrogen(BUN)],inflammatory factors[interleukin 6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)]and blood phosphorus levels in the observation group were significantly lower than those in the control group(P<0.05),while the blood calcium level in the observation group was significantly higher than that in the control group(P<0.05).The incidence of adverse drug reactions in the observation group was 4.08%,which was significantly lower than 18.37%in the control group(P<0.05).Conclusion HD+HP regimen is effective in the treatment of CRF,which can improve the renal function and micro inflammatory state of patients,maintain the stability of calcium and phosphorus metabolism,and has high safety.