不同血液透析方式治疗尿毒症瘙痒症疗效观察  

作　　者：刘娜利 陈斌 

机构地区：[1]湖北科技学院附属第一医院·咸宁市中心医院肾内科,湖北咸宁437000

出　　处：《中国药业》2020年第S01期17-18,共2页China Pharmaceuticals

摘　　要：目的探讨不同血液透析方式治疗尿毒症瘙痒症的疗效。方法选取医院血液透析中心2012年7月至2016年7月进行维持性透析治疗3个月以上的尿毒症皮肤瘙痒症患者80例,随机分为血液透析(HD)联合尿毒清组(A组)和血液透析+血液透析滤过(HD+HDF)组(B组),以及血液透析+血液灌流(HD+HP)组(C组),连续观察3个月透析患者的瘙痒情况,监测治疗前后甲状旁腺激素和血磷值。结果A组、B组皮肤瘙痒症状改善不明显,而C组皮肤瘙痒症状明显改善,有效率分别为37%,64%,76%,治愈率分别为6.7%,32%,40%;3组患者治疗前后的甲状旁腺激素及血磷均有显著差异(P<0.05),其中,B组和C组的治疗效果较A组好,C组最好。结论血液透析联合血液灌流在改善尿毒症瘙痒症临床症状和清除甲状旁腺激素及血磷方面都有明显疗效,可提高血液透析患者的透析效果及生活质量,值得推广。Objective To investigate the effect of different hemodialysis methods in the treatment of uremic pruritus.Methods Totally 80 patients with uremic pruritus treated with maintenance dialysis for more than 3 months in the hemodialysis center of our hospital from July 2012 to July 2016 were randomly divided into hemodialysis(HD)combined with Niaoduqing group(group A),hemodialysis+hemodiafiltration(HD+HDF)group(group B),and hemodialysis+hemoperfusion(HD+HP)group(group C).The pruritus of dialysis patients were observed continuously for 3 months.The parathyroid hormone and blood phosphorus values before and after treatment were monitored.Results The pruritus symptoms in group A and group B were not significantly improved,while those in group C were significantlyimproved,theeffectiverateswere 37%,64%,76%,andthecureratesingroupA,B,Cwere6.7%,32%and40%,respectively.The parathyroid hormone and blood phosphorus of the three groups before and after treatment were significantly different(P<0.05),and the treatment effect of group B and group C was better than that of group A,and group C was the best.Conclusion Hemodialysis combined with hemoperfusion has obvious effect on improving the clinical symptoms of uremic pruritus and clearing parathyroid hormone and blood phosphorus.It can improve the dialysis effect and quality of life of hemodialysis patients,which is worthy of promotion.

关 键 词：尿毒症瘙痒症 血液透析 血液灌流 血液透析滤过 

分 类 号：R457[医药卫生—治疗学]