血液透析与血液灌流联合治疗尿毒症心包积液临床观察

Observation on the clinical effects of hemoperfusion combined with hemodialysis for uremia combined pericardial effusion

目的探讨血液透析与血液灌流联用治疗尿毒症心包积液的临床疗效。方法选择2011年5月至2015年10月在吉林大学第一医院透析的尿毒症心包积液患者30例为研究对象。将患者分为对照组和观察组,每组各15例。比较两组患者的好转率,治疗前与治疗后4周血清C反应蛋白(CRP)、甲状旁腺激素(PHT)、血肌酐(Cr)含量,同时检测心包积液量及心功能。结果观察组患者治疗4周好转率为86.6%,显著高于对照组的46.6%,组间比较,差异有统计学意义(P<0.05)。观察组、对照组治疗后CRP、PTH、Cr含量均明显低于治疗前,且观察组治疗后低于对照组,组间比较,差异有统计学意义(P<0.05)。治疗后,观察组心包积液量也明显减少,且低于对照组(P<0.05);心功能的改善情况优于对照组(P<0.05)。结论血液透析与血液灌流联合治疗尿毒症心包积液,能有效减少心包积液量,改善心功能,清除炎症因子。

Objective The clinical value of hemoperfusion(HP) combined with hemodialysis(HD) in the treatment of pericardial effusion in patients with uremia. Methods Thirty cases of uremic with pericardial effusion in the First Hospital of Jilin University ICU and Nongan Hospital were studied from May 2011 to October 2015. All cases were divided into control group and observation group by random number table method. The 15 patients in the observation group were treated by HD and HP combination therapy,and the control group of 15 patient were treated by convertinol HD methods.Measure the heart function and the volume of pericardial eftusion,as well as levels of inflammatory cytokines CRP,serum PTH and Scr during the study. Results The volume of pericardial effusion, serum CRP,PTH and Cr levels in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the heart function in obsvervation group were singnificantly better than in control group(P<0.05). Conclusion HD and HP combination therapy for uremia patients with pericardial effusion can effectively reduce serum inflammatory and volume of pericardial effusion, and improve the heart function singnificantty.