不同血液净化治疗尿毒症患者药物性脑病的疗效观察  

Observation of efficacy of different blood purification methods on drug-induced encephalopathy in patients with uremia

作　　者：李在楠[1] LI Zai-nan(Chifeng Hospital Blood Purification Center,Chifeng 024000,China)

机构地区：[1]赤峰市医院血液净化中心,024000

出　　处：《中国实用医药》2022年第21期57-59,共3页China Practical Medicine

摘　　要：目的对比血液透析(HD)联合血液灌流(HP)与连续性静脉-静脉血液滤过(CVVH)联合血液灌流治疗尿毒症患者药物性脑病的临床疗效。方法32例应用抗菌药物治疗后出现药物性脑病的尿毒症患者,按治疗方法不同分为对照组(17例)和观察组(15例)。对照组采用血液透析联合血液灌流治疗,观察组采用连续性静脉-静脉血液滤过联合血液灌流治疗。比较两组患者治疗效果、意识状态改善有效和显效时间、住院时间及不良事件发生率。结果观察组患者治疗总有效率为86.67%,高于对照组的52.94%,差异有统计学意义(P<0.05)。观察组患者意识状态改善有效时间(1.35±0.47)d、意识状态改善显效时间(4.87±2.11)d及住院时间(6.05±2.03)d均短于对照组的(2.03±0.58)、(6.47±2.09)、(7.75±2.25)d,差异有统计学意义(P<0.05)。观察组患者不良事件发生率13.33%低于对照组的47.06%,差异有统计学意义(P<0.05)。结论连续性静脉-静脉血液滤过联合血液灌流治疗尿毒症患者药物性脑病效果显著优于血液透析联合血液灌流,可明显缩短患者治疗时间,且安全性更高。Objective To compare the clinical efficacy of hemodialysis(HD)combined with hemoperfusion(HP)and continuous veno-venous hemofiltration(CVVH)combined with hemoperfusion on drug-induced encephalopathy in patients with uremia.Methods A total of uremic patients with drug-induced encephalopathy after antibiotic treatment were divided into control group(17 cases)and observation group(15 cases)according to different treatment methods.The control group was treated with hemodialysis combined with hemoperfusion,and the observation group was treated with continuous venous-venous hemofiltration combined with hemoperfusion.The therapeutic effect,time to effective and markedly effective improvement in consciousness,hospitalization time,and incidence of adverse events were compared between the two groups.Results The total effective rate in the observation group was 86.67%,which was higher than 52.94%in the control group,and the difference was statistically significant(P<0.05).The time to effective and markedly effective improvement of the observation group were(1.35±0.47)and(4.87±2.11)d,and the hospitalization time was(6.05±2.03)d,which were shorter than(2.03±0.58),(6.47±2.09),and(7.75±2.25)d in the control group,and the differences were all statistically significant(P<0.05).The incidence of adverse events 13.33%in the observation group was lower than 47.06%in the control group,and the difference was statistically significant(P<0.05).Conclusion Continuous veno-venous hemofiltration combined with hemoperfusion is significantly more effective than hemodialysis combined with hemoperfusion in the treatment of drug-induced encephalopathy in uremic patients,and can significantly shorten the treatment time of patients with higher safety.

关 键 词：血液透析 连续性静脉-静脉血液滤过 血液灌流 尿毒症 药物性脑病 

分 类 号：R692.5[医药卫生—泌尿科学]