碳酸镧联合血液灌流对比碳酸镧联合血液透析滤过对降低慢性肾衰竭患者血磷和减轻皮肤瘙痒的临床疗效观察

Clinical efficacy observations of lanthanum carbonate combined with blood perfusion versus lanthanum carbonate combined with hemodialysis filtration on the reduction of serum phosphorus and skin itch for chronic renal failure patients

目的探究碳酸镧联合血液灌流对比碳酸镧联合血液透析滤过在降低慢性肾衰竭患者血磷和减轻皮肤瘙痒中的应用价值。方法将江门市新会区第二人民医院在2022年5月~2023年5月期间收治的88例慢性肾衰竭并高磷血症伴皮肤瘙痒患者作为本次研究对象,通过随机数字表法获得对照组(44例,口服碳酸镧咀嚼片联合血液透析滤过治疗)与研究组(44例,口服碳酸镧咀嚼片联合血液灌流治疗),比较两组患者治疗效果、治疗前后血钙、血磷与甲状腺素,并发症发生率与皮肤瘙痒改善情况。结果与对照组治疗总有效率81.82%相比,研究组95.45%较高(P<0.05)。治疗前,两组患者血钙、血磷以及甲状腺素水平差异无统计学意义(P>0.05),治疗后,两组患者血钙水平上升,血磷与甲状腺素水平均降低,其中,与对照组相比,研究组各指标变化幅度较大(P<0.05)。和对照组相比,研究组并发症总发生率较低(13.64%vs.2.27%),皮肤瘙痒改善率较高(75.00%vs.90.91%)(P<0.05)。结论与碳酸镧联合血液透析滤过治疗相比,在慢性肾衰竭患者中应用碳酸镧联合血流灌注治疗效果较优,能够有效改善患者血钙、血磷与甲状腺素水平,提升皮肤瘙痒改善率与治疗效果。

Objective To explore the applied value of lanthanum carbonate combined with blood perfusion versus lanthanum carbonate combined with hemodiacysis filtration on the reduction of serum phosphorus and skin itch for chronic renal failure patients.Methods 88 chronic renal failure patients with hyperphosphatemia and skin itch admitted to The Second People’s Hospital of Xinhui District(2022.5~2023.5)were chosen as research subjects.According to random number table,patients were assigned to the control group(n=44,lanthanum carbonate tablets combined with hemodiacysis filtration)and the study group(n=44,lanthanum carbonate combined with blood perfusion).Treatment effects,serum calcium,serum phosphorus,thyroxine before and after treatment,clinical complications and skin itch improvement condition were compared.Results The total effective treatment rates in the study group(95.45%)were higher than the control group(81.82%)(P<0.05);before treatment,serum calcium,serum phosphorus and thyroxine contents between groups were not significantly different(P>0.05);after treatment,serum calcium contents for two groups were increased while serum phosphorus and thyroxine contents were reduced.The fluctuation degrees of serum calcium,serum phosphorus and thyroxine contents in the study group were even higher than the control group(P<0.05);the total complication rates in the study group were lower than the control group(13.64%vs.2.27%);the skin itch improvement rates in the study group were higher than the control group(75.00%vs.90.91%,P<0.05).Conclusion Compared to lanthanum carbonate combined with hemodialysis filtration,the application of lanthanum carbonate combined with blood perfusion in patients with chronic renal failure has a better effect.It can effectively improve the levels of serum calcium,serum phosphorus,and thyroid levels in patients,and enhance the skin itch improvement rates and treatment effect.