比较血液透析滤过(HDF)与血液透析(HD)联合血液灌流(HP)在尿毒症顽固性高血压中的治疗效果  

Effect of Comparing the Treatment of Hemodiafiltration(HDF)and Hemodialysis(HD)combined with Perfusion(HP)in Refractory Hypertension of Uremia

作　　者：姜晓丽 JIANG Xiao-li(Department of Artifi cial Nephrology,Dalian Lvshunkou District People's Hospital,Dalian 116041,China)

机构地区：[1]辽宁省大连市旅顺口区人民医院人工肾科,辽宁大连116041

出　　处：《中国医药指南》2020年第18期19-21,共3页Guide of China Medicine

摘　　要：目的对血液透析过滤与血液透析联合血液灌流治疗尿毒症顽固性高血压的临床治疗效果展开探讨。方法于2018年11至2019年10月,选取我院收治的60例需要进行血液透析治疗的尿毒症顽固性高血压患者。将患者随机分为观察组和对照组,每组各30例患者。对照组采用血液透析滤过对组内患者进行治疗,观察组采用血液透析联合血液灌流对组内患者进行治疗,两组患者均每周接受3次透析治疗,待6个月后观察对比两组患者治疗前后血磷、血钙、全段甲状旁腺急速水平、收缩压、舒张压、平均动脉压以及不良反应发生情况。结果两组患者治疗前,血磷、血钙、全段甲状旁腺激素水平、收缩压、舒张压、平均动脉压差异没有统计学意义(P>0.05);治疗6个月后,观察组患者血钙、血磷、全段甲状旁腺激素水平均低于对照组,差异具有统计学意义(P<0.05)。观察组患者治疗后其收缩压、舒张压、平均动脉压均低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后均存在出现不良反应患者,但观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论对尿毒症顽固性高血压患者以血液透析联合血液灌流的方式进行透析治疗,其治疗效果显著高于单纯使用血液透析滤过治疗,能够明显降低患者的血钙、血磷、全段甲状旁腺激素水平提升患者身体功能,在降收缩压、舒张压以及平均动脉压上也有着显著的效果,能够很好的改善患者病情,促进疗效,并且能够控制不良反应发生率,治疗有效性与安全性均能得到保障,提升患者生活质量的同时强化医疗服务质量,帮助患者重拾治愈的信心,具有临床应用价值和推广价值。Objective To explore the clinical effect of hemodialysis fi ltration and hemodialysis combined with hemoperfusion in the treatment of uremic refractory hypertension.Methods From November 2018 to October 2019,60 patients with uremic refractory hypertension who need hemodialysis were selected from our hospital.Patients were randomly divided into observation group and control group,30 patients in each group.The patients in the control group were treated by hemodialysis fi ltration,the patients in the observation group were treated by hemodialysis combined with hemoperfusion,and the patients in the two groups were treated by dialysis three times a week.After six months,the patients in the two groups were observed and compared before and after treatment,including blood phosphorus,calcium,rapid level of the whole parathyroid gland,systolic pressure,diastolic pressure,mean arterial pressure and adverse reactions situation.Results Before treatment,there was no signifi cant difference in serum phosphorus,calcium,parathyroid hormone,systolic blood pressure,diastolic blood pressure and mean arterial pressure between the two groups(P>0.05);after 6 months of treatment,the levels of calcium,phosphorus and parathyroid hormone in the observation group were lower than those in the control group(P<0.05).After treatment,the systolic pressure,diastolic pressure and mean arterial pressure in the observation group were lower than those in the control group,the difference was statistically significant(P<0.05).However,the total incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion The effect of hemodialysis combined with hemoperfusion in the treatment of uremic refractory hypertension is signifi cantly higher than that of hemodialysis alone.It can signifi cantly reduce the level of calcium,phosphorus and parathyroid hormone in the blood and improve the body function of patients.It also has signifi cant effect in reducing systolic pressure,diastolic pressure and average arteri

关 键 词：血液透析滤过 血液透析 血液灌流 尿毒症 顽固性高血压 

分 类 号：R544.1[医药卫生—心血管疾病]