血液灌流联合血液透析对尿毒症皮肤瘙痒患者临床疗效、激素水平及肾功能的影响

Effects of Hemoperfusion Combined with Hemodialysis on Clinical Efficacy, Hormone Levels and Renal Function in Patients with Uremic Pruritus

目的 分析血液灌流联合血液透析对尿毒症皮肤瘙痒患者临床疗效、激素水平及肾功能的影响。方法 选择2018年5月—2021年5月104例尿毒症皮肤瘙痒的临床资料进行回顾性分析,根据治疗方法将其分为对照组51例和观察组53例。对照组给予血液透析治疗,观察组给予血液灌流联合血液透析治疗。比较2组临床疗效及并发症,观察2组治疗前后血尿素(BUN)、血肌酐(Scr)、血钙、血磷、甲状旁腺激素(PTH)水平以及瘙痒程度评分、瘙痒缓解时间。结果 观察组临床总有效率为92.45%(49/53)高于对照组74.51%(38/51)(P<0.05)。治疗后,2组血钙、血磷、PTH、BUN、Scr水平以及瘙痒程度评分均低于治疗前,且观察组低于对照组(P<0.05)。治疗后,2组瘙痒缓解时间短于治疗前,且观察组短于对照组(P<0.05)。2组并发症总发生率比较差异无统计学意义(P>0.05)。结论 血液灌流联合血液透析能够有效降低尿毒症皮肤瘙痒患者血钙、血磷、PTH水平,改善残余肾功能,具有较高的临床疗效及安全性。

Objective To analyze the effect of hemoperfusion combined with hemodialysis on clinical efficacy,hormone level and renal function in patients with uremic pruritus(UP).Methods Clinical data of 104 patients with UP from May 2018 to May 2021 were retrospectively analyzed,and were divided into control group(n=51)and observation group(n=53)according to treatment methods.The control group was treated with hemodialysis,and the observation group was treated with hemoperfusion combined with hemodialysis.The clinical efficacy and complications of the two groups were compared.The levels of blood urea nitrogen(BUN),blood creatinine(Scr),blood calcium,blood phosphorus,parathyroid hormone(PTH)before and after treatment,itching degree score and time to itching relief of the two groups were observed.Results The total effective rate of observation group was significantly higher than that of control group[92.45%(49/53)vs.74.51%(38/51)](P<0.05).After treatment,the levels of blood calcium,blood phosphorus,PTH,BUN,Scr and itching degree in the two groups were lower than those before treatment,and lower in the observation group than in the control group(P<0.05).After treatment,the time to itching relief in the two groups was shorter than that before treatment,and shorter in the observation group than in the control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Hemoperfusion combined with hemodialysis can effectively reduce the levels of blood calcium,blood phosphorus and PTH,and improve residual renal function in patients with UP.It has high clinical efficacy and safety.