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目的:探讨血液透析联合血液灌流治疗尿毒症并发症的治疗效果。方法:入选该院2014年1月至2015年6月在门诊行血液透析的患者36例,所有患者透析剂量相似,每周行2~3次透析,4 h/次,透析时间超过2年。所有患者实施血液透析联合血液灌流,灌流2~3 h后采用血液透析1~2 h,常规的血液透析治疗,2~3次/w,4 h/次,血流量200~250 ml/min,透析器相同。联合治疗1次/w,连续治疗8 w。观察治疗前后临床症状和化验检查的变化。结果:治疗后患者皮肤瘙痒的缓解率为77.78%,食欲减退缓解率73.33%,睡眠障碍总缓解率64.52%,骨痛总缓解率72%,不安腿综合征78.57%,患者的血肌酐、血尿素氮以及甲状旁腺素治疗后均较治疗前明显下降,差异具有统计学意义(P<0.05。结论:血液透析联合血液灌流治疗尿毒症并发症能显著减少患者血中的毒素,改善患者的症状,但联合治疗费用较高,患者的依从性较差,很难长期维持。另外症状缓解的持续时间以及是否可完全逆转症状,还有待进一步循证医学研究的证实。
Objective: To investigate the therapeutic effect of hemodialysis combined with hemoperfusion on the complications of uremia. Methods: Thirty-six patients undergoing hemodialysis at outpatient department from January 2014 to June 2015 were enrolled in this study. All patients received similar dialysis doses. The patients were dialyzed twice or three times per week for 4 hours and dialyzed for more than two years. All patients underwent hemodialysis combined with hemoperfusion. After 2 ~ 3 h perfusion, hemodialysis was performed for 1 ~ 2 h, routine hemodialysis treatment was performed, 2 ~ 3 times / w, 4 h / time, blood flow was 200 ~ 250 ml / The same dialyzer. Combination therapy 1 / w, continuous treatment 8 w. Observed before and after treatment of clinical symptoms and laboratory changes. Results: The rate of skin pruritus was 77.78%, the rate of loss of appetite was 73.33%, the rate of total sleep remission was 64.52%, the rate of total pain relief was 72%, the restless leg syndrome was 78.57%, the serum creatinine, blood Blood urea nitrogen and parathyroid hormone after treatment were significantly lower than before treatment, the difference was statistically significant (P0.05) .Conclusion: Hemodialysis combined with hemoperfusion treatment of uremic complications can significantly reduce the blood toxins in patients with to improve the patient’s Symptoms, but the higher cost of combination therapy, patients with poor compliance, it is difficult to maintain long-term.In addition, the duration of symptom relief and whether the symptoms can be completely reversed, remains to be confirmed by evidence-based medical research.