血液透析、血液滤过、血液灌流不同组合方式治疗慢性肾衰竭尿毒症的临床疗效观察  

Clinical effect of different combination of hemodialysis,hemofiltration and hemoperfusion on uremia of chronic renal failure

作　　者：张娜[1] 张磊[1] 杜宇[1] 田加坤 曹微[1] 张谊雯 杜芸 Zhang Na;Zhang Lei;Du Yu;Tian Jiakun;Cao Wei;Zhang Yiwen;Du Yun(Department of Nephrology,the First Peoples Hospital of Lianyungang City,Lianyungang 2200,China)

机构地区：[1]连云港市第一人民医院肾内科,连云港222000

出　　处：《国际泌尿系统杂志》2021年第3期516-519,共4页International Journal of Urology and Nephrology

摘　　要：目的研究血液滤过、血液灌流、血液透析不同组合方式治疗慢性肾衰竭尿毒症的临床疗效。方法选取2017年1月至2019年8月本院收治的96例慢性肾衰竭患者纳入研究样本,依照随机数字表法,分为观察组和对照组,各48例,其中观察组采用血液透析联合血液灌流治疗,对照组采用血液透析联合血液滤过治疗,两组均持续治疗3个月。比较两组治疗前后血钾(K^(+))、血磷(P^(3+))、血钙(Ca^(2+))、血浆内皮素(ET)、血管紧张素Ⅱ(ATⅡ)水平,并分析两组治疗前后血生化指标血肌酐(Scr)、血尿素氮(BUN)、甲状旁腺素(PTH)、β2微球蛋白(β2-MG)、肾素(RA)水平。结果两组患者治疗后的K^(+)、P^(3+)、ET、ATⅡ水平均显著低于治疗前(P<0.05),且观察组上述各指标治疗后均低于对照组(P<0.05),Ca^(2+)水平在组内或组间比较,差异均无统计学意义(P>0.05)。两组患者治疗后的Ser、BUN、PTH、β2-MG、RA水平均显著低于治疗前(P<0.05);观察组患者治疗后的Scr、BUN、PTH、β2-MG、RA水平均显著低于对照组(P<0.05)。结论血液灌流联合血液透析治疗可有效清除慢性肾衰竭尿毒症患者机体循环内大部分毒素,值得临床应用推广。Objective To study the clinical effect of different combinations of hemodialysis,hemofiltration and hemoperfusion on uremia of chronic renal failure.Methods From January 2017 to Auguet 2019,96 uremic patients with chronic renal failure admitted to our hospital were included in the study.According to the random number table method,they were divided into two groups,48 cases in each group.The observation group was treated with hemodialysis combined with hemoperfusion,the control group was treated with hemodialysis and hemofiltration,and both groups were treated for three months.The levels of serum K^(+),P^(3+),Ca^(2+),ET and AT I were compared before and after treat-ment,and the levels of Ser,BUN,PTH,β2-MG and RA were analyzed before and after treatment.Results After treatment,the levels of K^(+),P^(3+),ET,ATI in the two groups were significantly lower than those before treatment(P<0.05),and the above indexes in the observation group were lower than those in the control group(P<0.05).There was no significant difference in Ca^(2+)level between groups(P>0.05).The levels of Scr,BUN,PTH,β2-MG and RA in the two groups were significant-ly lower than those before treatment(P<0.05).The levels of Scr,BUN,PTH,β2-MG and RA in the observation group were significantly lower than those in the control group p(P<0.05).Conclusions Hemodialysis combined with hemoperfusion is of great clinical value in the elimination of large and small molecular toxins in uremic patients with chronic renal failure.

关 键 词：尿毒症 肾透析 血液滤过 灌流 

分 类 号：R692.5[医药卫生—泌尿科学]