血液透析联合血液灌流与联合血液透析滤过对维持性血液透析患者皮肤瘙痒的疗效观察  

The efficacy of hemodialysis combined with hemoperfusion and hemodialysis combined with hemodiafiltration on pruritus in maintenance hemodialysis patients

作　　者：樊晓红[1] 熊重祥[1] 王新华[1] 胡静[1] 

机构地区：[1]上海市第七人民医院,上海200137

出　　处：《中国血液净化》2009年第3期137-141,共5页Chinese Journal of Blood Purification

摘　　要：目的探讨不同血液净化方式对维持性血液透析患者皮肤瘙痒的治疗效果。方法维持性血液透析患者38例,随机分为两组:血液灌流+血液透析(HP+HD)组18例,常规血液透析(HD)每周二次,其中一次血液灌流(HP)联合血液透析治疗;血液透析滤过+血液透析(HDF+HD)组20例,每周常规HD治疗两次,HDF治疗一次,疗程为12周。治疗前后观察血尿素氮(BUN)、肌酐(SCr)、血清钙(Ca2+)、磷(P3-)、甲状旁腺激素(PTH)的数值变化以及患者皮肤瘙痒缓解情况。结果HP+HD组患者皮肤瘙痒的缓解率为89%,高于HDF+HD组(60%),且差异有显著性(P<0.05);HP+HD组血P3-、PTH较HDF组下降明显(P<0.05);但BUN、SCr的下降程度两组间差异无显著性(P>0.05)。结论HP+HD能有效治疗尿毒症患者皮肤瘙痒且优于HDF+HD。Objective To investigate the efficacy of different blood purification method on pruritus in maintenance hemodialysis patients. Methods We randomly assigned 38 maintenance hemodialysis patients into hemodialysis combined with hemoperfusion （HD＋HP） group （18 cases） or hemodialysis combined with hemodiafiltration （HD＋HDF） group （20 cases）. Patients in the HD＋HP group were treated with hemodialysis once and hemodialysis combined with hemoperfusion once in a week for 12 weeks, and those in the HD＋HDF group were treated with hemodialysis once and hemodialysis combined with hemodiafiltration once in a week for 12 weeks. Before and after the treatment, blood urea nitrogen, creatinine, serum calcium, serum phosphate and iPTH were monitored, and the change of pruritus was evaluated. Results The remission rate of skin itch was higher in HD＋HP group （89%） than in HD＋HDF group （60%） （P〈0.05）. The decrease of serum phosphate and iPTH was more prominent in HD＋HP group than in HD＋HDF group （P〈0.05）, but the decrease of blood urea nitrogen and creatinine were statistically indifferent between the two groups （P 〉 0.05）. Conclusions HD＋HP is more effective than HD＋HDF in the treatment of pruritus in maintenance hemodialysis patients.

关 键 词：血液灌流 血液透析滤过 尿毒症 皮肤瘙痒 

分 类 号：R459.5[医药卫生—治疗学]