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目的血液透析滤过治疗尿毒症皮肤瘙痒的临床研究。方法选择尿毒症皮肤瘙痒患者40例;随机分为观察组(HDF组)及对照组(HD组),观察组在金宝AK-200血滤透析机上进行血液透析滤过、对照组在日机装DBB-27血透机上进行血液透析,每周2～3次,4 h/次,观察12周;透析前后检测血尿素氮BUN、肌酐SC r、尿酸UA、血磷P、甲状旁腺激素iPTH;用可视模拟评分法评估瘙痒程度。结果两组透析后各项生化指标,观察组优于对照组,皮肤瘙痒与治疗前均有减轻P<0.05。结论间断血液透析滤过与低通量透析相比,在对小分子毒素充分清除的基础上,增加了对大分子毒素的清除,可以明显减轻尿毒症患者皮肤瘙痒症状。
AIM: To investigate the clinical effect of hemodiafiltration on skin pruritus in uremic patients. Methods 40 patients with pruritus of uremic skin were randomly divided into observation group (HDF group) and control group (HD group). The observation group was dialyzed on Campbell AK-200 hemodialysis machine, Hemodialysis was performed on DBB-27 hemodialysis machine for 2 to 3 times a week for 4 h every time for 12 weeks. Blood urea nitrogen (BUN), creatinine (SCr), uric acid (UA), blood phosphorus (P), parathyroid hormone Visual acuity score was used to assess the degree of pruritus. Results The biochemical indexes of the two groups after dialysis were better in the observation group than in the control group, with pruritus being relieved before treatment (P <0.05). Conclusion Intermittent hemodiafiltration compared with low-flux dialysis, in the full removal of small molecule toxins based on the increase of the removal of macromolecular toxins, can significantly reduce the skin pruritus symptoms of uremia patients.