不同血液灌流连接方式对维持性血液透析患者肾性骨病的治疗效果及护理体会  

The therapeutic effect and nursing experience of different linked modes in hemodialysis combined with hemoperfusion on renal osteopathy disease in maintenance hemodialysis patients

作　　者：毕晓红[1] 吴岚[1] 王文峰[1] 乐萍[1] 

机构地区：[1]武汉大学中南医院肾内科,430071

出　　处：《中国实用护理杂志》2015年第23期1745-1747,共3页Chinese Journal of Practical Nursing

摘　　要：目的探讨血液透析过程中不同的血液灌流连接方式对维持性血液透析（MHD）患者肾性骨病疗效的影响及护理。方法以64例MHD合并肾胜骨病患者为研究对象，按照随机数字表法分成血液灌流前连接组（简称前连接组）和血液灌流后连接组（简称后连接组），每组32例。记录患者临床指标、生化指标及并发症，比较2种血液灌流连接方式治疗MHD患者肾性骨病的效果。结果后连接组血清全段甲状旁腺激素（iPTH）水平较前连接组低[（133．02±38．63）n#L比（191．36±53．96）ng／L]，差异有统计学意义，t=3．517，P〈0．05；后连接组低血压和体外循环凝血发生率明显低于前连接组[8．85％（51／576）比14．93％（86／576）和6．94％（40，576）比15．97％（92／576）]，差异有统计学意义x2=10．149和23．136，P〈0．01。结论后连接式血液灌流能够明显降低MHD合并肾性骨病患者iPTH水平，且后连接方式并发症相对较少，值得临床广泛推广。Objective To explore the therapeutic effect and nursing points of different linked modes in hemodialysis combined with hemoperfusion on renal osteopathy disease in maintenance hemodialysis （MHD） patients. Methods Sixty-four MHD patients with renal osteopathy disease were enrolled in the study. They were divided into two groups by random digits table method： the front connection group and the back connection group with 32 cases each. Their clinical data, serum parameters and complications were recorded. The therapeutic effect of two groups were compared. Results The serum level of intact parathyroid hormone（iPTH ） was （191.36 ± 53.96） ng/L in the front connection group,while （133.02 ± 38.63 ） ng/L in the back connection group,and there was significant difference, t=3.517,P〈0.05.The incidence of lower blood pressure and blood coagulation were 8.85%（51/576）, 6.94%（40/576） in the back connection group, while 14.93%（86/576）, 15.97%（92/576） in the front connection group, and there were significant differences, ）（2=10.149, 23.136, P〈0.01. Condusion The back linked mode in hemodialysis combined with hemoperfu- sion can obviously decrease iPTH of MHD patients combined with renal osteopathy disease and has less compli- cations, worth clinical promotion.

关 键 词：肾透析 血液灌流 肾性骨病 

分 类 号：R473.5[医药卫生—护理学]