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目的:探讨常规血液透析加血液灌流对尿毒症继发甲状旁腺功能亢进(SHPT)的疗效。方法:在2014年2月至2015年11月惠州市中医医院收治尿毒症继发SHPT患者中随机抽取的83例。将上述83例尿毒症继发SHPT患者随机分为透析组41例和联合组42例。透析组采取常规血液透析治疗,联合组采取常规血透加血液灌流治疗。比较(1)尿毒症继发SHPT治疗效果;(2)住院费用;(3)干预前和干预后患者血磷、钙磷乘积、甲状旁腺激素的差异。结果:(1)联合组较之透析组尿毒症继发SHPT治疗效果更高,差异具有统计学意义(P<0.05);(2)联合组较之透析组住院费用更高,(P<0.05);(3)干预前两组血磷、钙磷乘积、甲状旁腺激素相似,(P>0.05);干预后联合组较之透析组血磷、钙磷乘积、甲状旁腺激素改善更显著,差异具有统计学意义(P<0.05)。结论:常规血透加血液灌流对尿毒症继发SHPT虽然治疗费用有所增加,但疗效确切,可有效改善患者临床症状和生化指标,在患者经济能力可承受的情况下可选择。
Objective: To investigate the effect of conventional hemodialysis plus hemoperfusion on uremia secondary hyperparathyroidism (SHPT). Methods: From February 2014 to November 2015, 83 cases of patients with ureteral secondary SHPT were randomly selected in Huizhou Chinese Medicine Hospital. 83 patients with uremia secondary to SHPT were randomly divided into dialysis group of 41 patients and 42 patients in combination group. Dialysis group to take conventional hemodialysis treatment, the combined group to take conventional hemodialysis plus hemoperfusion treatment. Comparison of (1) secondary SHPT treatment of uremia; (2) hospitalization costs; (3) before and after intervention in patients with phosphorus, calcium and phosphorus products, parathyroid hormone differences. Results: (1) The combined treatment group had a higher effect than SHPT in secondary dialysis group, the difference was statistically significant (P <0.05); (2) The hospitalization cost was higher in the combination group than in the dialysis group (P <0.05 ); (3) The serum phosphorus, calcium and phosphorus products and the parathyroid hormone were similar in the two groups before intervention (P> 0.05); after intervention, the combination of serum phosphorus, calcium and phosphorus and parathyroid hormone improved more significantly , The difference was statistically significant (P <0.05). CONCLUSION: The conventional hemodialysis plus hemoperfusion has an obvious curative effect on the treatment of ureteral secondary SHPT, but it can effectively improve the clinical symptoms and biochemical indexes of patients, which can be chosen under the condition that patients’ financial capacity can be tolerated.