组合性人工肾对维持血液透析患者预后的影响  

Effects of combination artificial kidney on the prognosis of patients with maintenance hemodialysis

作　　者：肖健[1] 马兵[1] 石平[1] 刘仙蓉[1] 张雪芹[1] 

机构地区：[1]四川省广元市中心医院肾病内科,628000

出　　处：《河北医药》2016年第17期2619-2621,2625,共4页Hebei Medical Journal

摘　　要：目的分析组合性人工肾对维持血液透析患者预后的影响。方法选择2015年1~6月收治的维持血液透析患者84例,随机分为2组,42例给予组合性人工肾（HD＋HP）透析患者为HD＋HP组,42例采用常规血液透析（HD）患者为HD组,比较透析前、透析3个月后血压、血磷、全段甲旁腺素（iPTH）和皮肤瘙痒及透析充分性,所有患者随访至2015年12月,比较2组患者综合状态和并发症发生率。结果透析12周后HD＋HP组血磷、iPTH和皮肤瘙痒评分均低于HD组（P〈0.05）,收缩压低于HD组（P〈0.05）,URR和KT/V均高于HD组（P〈0.05）。HD＋HP组平均随访（20.1±1.3）周,HD组平均随访（19.8±1.2）周。末次随访HD＋HP组BMI、URR、ALB和钙磷乘积达标率均高于HD组（P〈0.05）。HD＋HP组心血管并发症、皮肤骚痒、末梢神经感染异常和肾性骨病或关节病变发生率均低于HD组（P〈0.05）。结论组合性人工肾透析更充分,可清除常规血透不能清除的中、大分子毒素,利于血压的控制和钙磷平衡,提高终末期肾衰患者的综合状态,对改善患者的预后有利。Objective To observe the effects of combination artificial kidney on the prognosis of patients receiving maintenance hemodialysis. Methods Eighty-four patients who underwent maintenance hemodialysis in our hospital from January 2015 to June 2015 were randomly divided into two groups,in whom 42 patients were treated by combination artificial kidney dialysis（ HD ＋ HP group）,however,the other 42 patients were treated by conventional hemodialysis（ HD group）,and the changes of blood pressure,blood phosphorus,parathyroid hormone（ i PTH）,itch of skin and dialysis efficiency were observed and compared between two groups,with follow- up until December 2015 for all the patients,the general status and incidence of complicatioms were observed and compared between two groups. Results The levels of blood phosphorus,i PTH,skin itch scores and systolic pressure in HD ＋ HP group after 12- week dialysis were significantly lower than those in HD group（ P 0. 05）,however,the levels of URR and KT / V were significantly higher than those in HD group（ P 0. 05）.The average follow-up time in HD ＋ HP group was（ 20. 1 ± 1. 3） weeks,which in HD group was（ 19. 8 ± 1. 2） weeks. The levels of BMI,URR,ALB and up to the standard rate of calcium-phosphorus product in HD ＋ Hp group at the last folow-up were significantly higher than those in HD group（ P 0. 05）. The incidence rates of cardiovascular complications,skin itch,peripheral nerve infection,renal osteopathy or arthropathy in HD ＋ HP group were significantly lower than those in HD group（ P 0. 05）. Conclusion The effects of combination artificial kidney dialysis are superior to those of conventional hemodialysis,which can remove the middle or macromolecular toxins that can not be removed by conventional hemodialysis,moreover,which can control blood pressures and calcium- phosphorus balance,improve the general status and prognosis of patients with terminal stage renal failure.

关 键 词：组合性人工肾 维持血液透析 治疗结果 

分 类 号：R459.5[医药卫生—治疗学]