血液灌流联合腹膜透析治疗终末期肾脏病的效果研究  

Therapeutic effect of hemoperfusion combined with peritoneal dialysis on end-stage renal disease

作　　者：王树龙[1] 王云[1] 尚瑞华 鲍妍 韩惠淑 李瑾[1] 刘向东[1] Wang Shulong;Wang Yun;Shang Ruihua;Bao Yan;Han Huishu;Li Jin;Liu Xiangdong(Ward II,Nephrology Hospital,the First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院肾脏病医院二病区,新乡453100

出　　处：《中国实用医刊》2023年第20期47-50,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨血液灌流联合腹膜透析治疗终末期肾脏病(ESRD)的效果。方法抽取2020年1月至2022年12月新乡医学院第一附属医院肾脏病医院收治的需肾脏替代治疗的ESRD患者76例为研究对象,按照随机数字表法分为对照组和研究组,每组38例。两组均进行饮食调整、容量管理、控制血压及原发基础疾病治疗,在此基础上采用肾脏替代治疗方式,研究组采用每周2次HP和腹膜透析联合治疗,对照组仅采用腹膜透析,两组患者均治疗4周。比较两组治疗效果、炎性因子水平、肾功能指标水平、生存率以及并发症发生率。结果治疗后研究组总有效率(30/38,78.94%)高于对照组(22/38,57.89%),P<0.05;治疗后两组患者血红蛋白均较治疗前升高,且研究组高于对照组(P<0.05);治疗后两组尿蛋白及肾小球滤过率均较治疗前降低,且治疗后研究组尿蛋白水低于对照组,肾小球滤过率高于对照组(P<0.05);治疗后两组肿瘤坏死因子-α、白细胞介素-6、白细胞介素-8水平较治疗前降低,且研究组低于对照组(P<0.05);两组治疗后6个月和1年生存率比较差异未见统计学意义(P>0.05),两组恶心、腹痛、皮下瘀点等并发症发生率比较差异未见统计学意义(P>0.05)。结论血液灌流联合腹膜透析治疗ESRD需肾脏替代治疗患者,患者炎性因子水平以及并发症发生情况明显改善,治疗效果较好,安全性较高。ObjectiveTo investigate the clinical efficacy of hemoperfusion combined with peritoneal dialysis on patients with end-stage renal disease(ESRD).MethodsSeventy-six patients with ESRD who needed kidney replacement therapy hospitalized in the First Affiliated Hospital of Xinxiang Medical University from January 2020 to December 2022 were selected as the study objects,and they were divided into control group and study group by random number table method,with 38 patients in each group.Diet regulation,volume management,blood pressure control and primary underlying disease treatment were performed in both groups.The study group was treated by hemoperfusion and peritoneal dialysis twice a week,while the control group was treated by peritoneal dialysis only.Both groups were treated for 4 weeks.The treatment effect,levels of inflammatory factors,renal function indexes,survival rate and incidence of complications of the two groups were compared.ResultsAfter treatment,the total effective rate of the study group(30/38,78.94%)was higher than that of the control group(22/38,57.89%),P<0.05.After treatment,the hemoglobin level of the two groups were higher than those before treatment,and the hemoglobin level of the study group was higher than that of the control group(P<0.05).After treatment,the urinary protein and glomerular filtration rate in the two groups were lower than those before treatment,moreover,the study group had lower urine protein level and higher glomerular filtration rate than the control group(P<0.05).After treatment,the levels of tumor necrosis factor-α,interleukin-6 and interleukin-8 in the two groups were lower than those before treatment,and these indexes in the study group were lower than those in the control group(P<0.05).There was no significant difference in the 6-month and 1-year postoperative survival rate between the two groups(P>0.05).And there was no significant difference in the incidence of complications between the two groups,such as nausea,abdominal pain and subcutaneous petechiae(P>0.05).Concl

关 键 词：血液灌流 腹膜透析 肾功能 慢性肾衰竭 

分 类 号：R692[医药卫生—泌尿科学]