血液透析和腹膜透析对终末期肾病患者的影响  

Effect of Hemodialysis and Peritoneal Dialysis on Patients With End-stage Renal Disease

作　　者：宋新宇[1] 马飞[1] SONG Xinyu;MA Fei(Blood Purification Center,Chifeng Municipal Hospital,Chifeng Inner Mongolia 024000,China)

机构地区：[1]赤峰市医院血液净化中心,内蒙古赤峰024000

出　　处：《中国卫生标准管理》2022年第14期72-77,共6页China Health Standard Management

摘　　要：目的探讨腹膜透析替代治疗对终末期肾脏病患者钙磷代谢、炎症因子及营养状态、并发症的影响。方法回顾2016年5月—2021年5月期间赤峰市医院血液净化中心收治的终末期肾脏病患者68例,将患者随机分为两组,血液透析组应用血液透析治疗,腹膜透析组应用腹膜透析替代治疗:持续循环腹膜透析替代治疗(continuous circulation peritoneal dialysis replacement therapy,CAPD),分析两种透析方式对患者钙磷代谢以及炎性因子及营养状态、并发症的影响。结果腹膜透析组全型甲状旁腺激素(83.4±10.3)pmol/L、血磷(1.3±0.5)mmol/L水平明显低于血液透析组全型甲状旁腺激素(106.5±12.3)pmol/L、血磷(1.9±0.5)mmol/L,差异有统计学意义(P<0.05),腹膜透析组校正钙、钙磷乘积与血液透析组差异无统计学意义(P>0.05);腹膜透析组CRP(18.3±3.5)mg/L的上升水平明显低于血液透析组CRP(24.1±3.6)mg/L,差异有统计学意义(P<0.05);透析前,两组患者的舒张压、收缩压、尿素氮、血肌酐水平之间的差异无统计学意义(P>0.05),透析后,腹膜透析组患者的舒张压、收缩压、尿素氮、血肌酐水平均低于血液透析组,差异有统计学意义(P<0.05);两组患者透析后的舒张压、收缩压、尿素氮、血肌酐水平均低于透析前,差异有统计学意义(P<0.05)。腹膜透析组患者的总有效率96.08%(49/51)高于血液透析组,透析充分率80.39%(41/51)高于血液透析组,尿路感染控制率94.12%(48/51)高于血液透析组,心律失常、感染、高血压、低蛋白血症以及充血性心力衰竭等并发症发生率低于血液透析组,腹膜透析组营养不良发生率为64.7%,血液透析组营养不良发生率为82.4%,腹膜透析组营养状态优于血液透析组,差异有统计学意义(P<0.05)。结论在针对终末期肾脏病患者进行治疗的过程中,腹膜透析替代治疗的治疗方式对患者钙磷代谢、炎症反应程度以及营养状态的影响程度�Objective To investigate the effects of peritoneal dialysis replacement therapy on calcium and phosphorus metabolism,inflammatory factors,nutritional status and complications in patients with end-stage renal disease.Methods 68 patients with end-stage renal disease treated in the Blood Purification Center of Chifeng Hospital from May 2016 to May 2021 were reviewed.The patients were randomly divided into two groups.The hemodialysis group was treated with hemodialysis,and the peritoneal dialysis group was treated with peritoneal dialysis replacement therapy:continuous circulation peritoneal dialysis replacement therapy(CAPD).The effects of two dialysis methods on calcium and phosphorus metabolism,inflammatory factors,nutritional status and complications were analyzed.Results The levels of total parathyroid hormone(83.4±10.3)pmol/L and blood phosphorus(1.3±0.5)mmol/L in the peritoneal dialysis group were significantly lower than those in the hemodialysis group(106.5±12.3)pmol/L and blood phosphorus(1.9±0.5)mmol/L,the difference was statistically significant(P<0.05);The rising level of CRP(18.3±3.5)mg/L in peritoneal dialysis group was significantly lower than that in hemodialysis g r o u p(24.1±3.6)m g/L,t h e d i ff e r e n ce was statistically significant(P<0.05).Before dialysis,there was no significant difference between the levels of diastolic pressure,systolic pressure,urea nitrogen and blood creatinine between the two groups(P>0.05).After dialysis,the levels of diastolic pressure,systolic pressure,urea nitrogen and blood creatinine in the peritoneal dialysis group were lower than those in the hemodialysis group,and the difference was statistically significant(P<0.05);The levels of diastolic blood pressure,systolic blood pressure,urea nitrogen and blood creatinine in the two groups after dialysis were lower than those before dialysis,and the difference was statistically significant(P<0.05).The total effective rate of peritoneal dialysis group was 96.08%(49/51)higher than that of hemodialysis group,the dial

关 键 词：腹膜透析替代治疗 血液透析 终末期肾病 钙磷代谢 炎症因子 营养状态 

分 类 号：R692[医药卫生—泌尿科学]