血液透析联合血液灌流治疗模式在尿毒症患者中的应用研究  

Study of Application of Hemodialysis Combined with Hemoperfusion in Uremia Patients

作　　者：杨梅春 龙奇军[2] 邓飘阳 李海浪 韦庆妹 谢玉韵 凌彩霞[1] 蓝金艳 

机构地区：[1]右江民族医学院附属医院,广西 百色 [2]右江民族医学院,广西 百色

出　　处：《临床医学进展》2021年第9期4059-4067,共9页Advances in Clinical Medicine

摘　　要：目的:探讨采用血液透析联合血液灌流(HD + HP)治疗模式在尿毒症患者中的应用研究。方法:2020年1月~2020年12月期间,在本院治疗该症患者中选取60例持续进行血液透析治疗的患者,采用随机分配的方式将60名患者分为研究组30例和对照组30例。对照组是采用血液透析(HD)的治疗模式,研究组是采用血液透析联合血液灌流(HD + HP)的治疗模式,在治疗期间对两个小组患者均采取优质护理干预,观察两组患者皮肤瘙痒状况,毒素清除率及微炎症状态、免疫功能、脂代谢、钙磷代谢、颈动脉内膜、护理满意度的影响,降血压效果。运用SF-36量表对两组患者进行生活质量评分对比。结果:研究组护理后瘙痒评分、Scr、BUN、β2-MG、PTH水平均较护理前显著下降,效果优于对照组(P 0.05)。治疗后对照组IMT及斑块面积均较治疗前明显增大(P 【0.05),治疗后研究组IMT及斑块面积明显小于对照组(P 【0.05)。研究组患者治疗3个月、6个月后的收缩压、舒张压、血浆肾素活性、血管紧张素II水平均低于对照组及治疗前,差异有统计学意义(P 【0.05);研究组护理满意度显著高于对照组(P 【0.05)。两组治疗后SF-36评分均捉高,其中研究组PF、RP、RE、MH、SF、BP、VT和GH评分均高于对照组(P 【0.05)。结论:HD + HP治疗模式可明显提高尿毒症患者中大分子毒素清除率,且有良好的降压效果。减轻患者机体炎性反应,改善免疫功能,能有效调节患者脂代谢及钙磷代谢水平,促进肾功能恢复的同时可有效延缓动脉粥样硬化等心血管并发症的发生。提高护理满意度,并改善患者的生活质量,值得推广应用。Objective: The objective is to investigate the application of hemodialysis combined with Hemoperfusion (HD + HP) in patients with uremia. Methods: From January 2020 to December 2020, 60 patients receiving continuous hemodialysis treatment were selected from the patients treated with this disease in our hospital, and the 60 patients were randomly divided into the study group (30 cases) and the control group (30 cases). The control group was treated with hemodialysis (HD). The study group was treated with hemodialysis combined with Hemoperfusion (HD + HP). During the treatment, the patients in the two groups were treated with high-quality nursing intervention, and the condition of skin pruritus in the two groups was observed. Effects of toxin clearance rate, microinflammatory status, immune function, lipid metabolism, calcium and phosphorus metabolism, carotid intima, nursing satisfaction and blood pressure lowering effect were observed. Quality of life scores were compared between the two groups using THE SF-36 scale. Results: The itching score, Scr, BUN, β2-MG and PTH levels of the study group were significantly decreased after nursing, and the effect was better than that of the control group (P 0.05). Both IMT and plaque area in the control group were significantly increased after treatment (P <0.05). IMT and plaque area in the treatment group were significantly lower than those in the control group (P <0.05). The systolic blood pressure, diastolic blood pressure, plasma renin activity and angiotensin II level in the study group after 3 and 6 months of treatment were lower than those in the control group and before treatment, the differences were statistically significant (P <0.05). Nursing satisfaction in the study group was significantly higher than that in the control group (P <0.05). SF-36 scores were higher in both groups after treatment. PF, RP, RE, MH, SF, BP, VT and GH scores in study group were higher than those in control group (P <0.05). Conclusion: HD + HP therapy can significantly im

关 键 词：血液透析 血液灌流 尿毒症患者 ESRD 

分 类 号：R47[医药卫生—护理学]