老年尿毒症患者血液透析滤过临床疗效  

A Clinical Study on Hemodiafiltration in Elderly Patients with Uremia

作　　者：李海波 何红 陈宝龙 徐捷 马立明 

机构地区：[1]北京市隆福医院血透室,北京100010

出　　处：《透析与人工器官》2007年第1期17-19,共3页Chinese Journal of Dialysis and Artificial Organs

摘　　要：目的探讨血液透析滤过(hem odiafiltration,HDF)对尿毒症患者不同分子量物质的清除率、患者耐受性及临床疗效。方法回顾性分析20例伴有血透并发症及不适症状的尿毒症患者行后稀释法HDF240例次并与22例仍行常规血液透析(HD)治疗的患者780例次进行比较,观察Kt/V,血清肌酐(Scr),尿素氮(BUN),血尿酸(UA),β2-微球蛋白下降率及治疗中患者血透常见并发症和不良反应发生率。结果患者对HDF治疗效果和耐受性显著优于HD,透析并发症和不适症状发生率显著低于HD(P<0.01),HDF治疗后血清Scr,BUN,UA,β2-M水平显著降低,KT/V明显增高。结论后稀释HDF能有效清除尿毒症患者血中大、中、小分子物质,透析效果显著提高。患者对该法治疗的耐受性明显提高。适用于易出现血透并发症及不适症状的尿毒症患者。Objective To study the clearance of uremia toxins, the tolerance of dialysis and clinical effect of hemodiafihration（HDF） in elderly patients with uremia. Methods The KT/V, the clearance of blood urea nitrogen （ BUN）, serum creatinine （ Scr）, serum uric acid （UA） β2-Microglobulin （ β2-M ）, rate of dialysis complications in 20 cases of ESRD patienes treated with HDF for 240 times were compared to those with hemodialysis （HD） ,22 cases for 740 times. Results HDF patients had better tolerance than that of HD, the rate of dialysis complications were much less in HDF patients than that of HD（ P 〈 0.01 ）. The clearance of BUN, Scr, UA and β2-M were better than that of HD. KT/ V increases greatly in patients treated with HDF. Conclusion The clearance of all sizes of uremic toxins were significantly better than that of HD. HDF increases the tolerance to dialysis and significantly improves the effect of dialysis.

关 键 词：尿毒症 血液透析滤过 血液透析 透析并发症 

分 类 号：R692.5[医药卫生—泌尿科学]