每日透析在血液透析诱导期中的应用  

Daily hemodialysis in induction period of hemodialysis: a clinical study of 44 cases

作　　者：刘伟[1] 王俭勤[1] 梁耀军[1] 王文革[1] 王晓玲[1] 孔玉科[1] 曾嵘[1] 

机构地区：[1]兰州大学第二医院肾病中心,兰州730030

出　　处：《第三军医大学学报》2016年第1期75-78,共4页Journal of Third Military Medical University

基　　金：甘肃省技术研究与开发专项计划(1205TCYA028);甘肃省泌尿系疾病临床医学中心开放课题(mnlczxkf-14)~~

摘　　要：目的比较每日透析和传统透析在诱导期血液透析中的应用,探讨每日透析用于诱导期血液透析的可行性及优势。方法将兰州大学第二医院肾病中心2013-2014年新进入血液透析治疗的慢性肾衰竭尿毒症患者44例区组随机分配到两个治疗组,其中传统诱导透析组(CHD)22例、每日透析组(DHD)22例。两组患者诱导透析前1 d和第7天时检测尿素氮(BUN)、血肌酐(Scr)、血红蛋白(Hb)、平均动脉压(MAP)、心率(HR)、APACHEⅡ评分,观察治疗期间失衡综合征等并发症及SCL-90量表中的头痛评分、恶心评分、睡眠障碍评分、焦虑评分、躯体化评分、总因子分。结果两组患者入院时BUN、Scr、Hb、MAP、HR、APACHEⅡ评分比较,差异均无统计学意义(P>0.05)。第7天,DHD组患者Scr、MAP、APACHEⅡ评分与CHD组比较,差异有统计学意义[分别为(465.44±117.70)vs(594.60±157.38),(99.71±12.23)vs(109.54±12.14),(13.71±2.13)vs(15.38±1.94),P<0.05]。DHD组头痛评分、恶心评分、睡眠障碍评分、焦虑评分、躯体化评分、总因子分与CHD组比较,差异有统计学意义[1.00 vs 2.00,1.00 vs 2.00,(1.53±0.43)vs(1.92±0.61),(1.28±0.34)vs(1.53±0.37),(1.50±0.46)vs(1.90±0.58),(1.38±0.38)vs(1.68±0.40),P<0.05]。结论在诱导透析期,每日透析代替传统透析能给患者提供一个高效、平稳、安全、舒适的血液净化过程。Objective To investigate the feasibility and advantages of daily hemodialysis（ DHD） by comparing the application of DHD and conventional hemodialysis（ CHD） in induction period. Methods Forty-four patients beginning to accept hemodialysis due to chronic renal failure in our center from 2013 to2014 were prospectively enrolled in this study,and then randomly divided DHD group（ n = 22） and CHD group（ n = 22）. Urea nitrogen（ BUN）,serum creatinine（ Scr）,hemoglobin（ Hb）,mean arterial pressure（ MAP）,heart rate（ HR）,and APACHEⅡ score were determined on 1 d before and on the 7th day after hemodialysis. Headache score,nausea score,somnipathy score,dysphoria score,somatization score and total score（ symptom check list-90,SCL-90） were also studied. Results On admission,there were no statistical differences in BUN,Cr,Hb,MAP,HR and APACHEⅡ score between the 2 groups（ P〉0. 05）. On the 7th day after the treatment,Scr（ 465. 44 ± 117. 70 vs 594. 60 ± 157. 38）,MAP（ 99. 71 ± 12. 23 vs 109. 54 ±12. 14） and APACHEⅡ score（ 13. 71 ± 2. 13 vs 15. 38 ± 1. 94） were statistically lower in the DHD group than the CHD group（ all P〈0. 05）. And the former group had obviously lower headache score（ 1. 00 vs2. 00）,nausea score（ 1. 00 vs 2. 00）,somnipathy score（ 1. 53 ± 0. 43 vs 1. 92 ± 0. 61）,dysphoria score（ 1. 28 ± 0. 34 vs 1. 53 ± 0. 37）,somatization score（ 1. 50 ± 0. 46 vs 1. 90 ± 0. 58） and total score（ 1. 38 ±0. 38 vs 1. 68 ± 0. 40） than the latter one（ all P〈0. 05）. Conclusion DHD,instead of CHD,is a safe,stable,high efficient and comfortable blood purification process in induction period.

关 键 词：血液透析 肾功能衰竭 尿毒症 

分 类 号：R459.5[医药卫生—治疗学] R692.5[医药卫生—临床医学]