高通量血液透析和常规血液透析的临床疗效比较
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摘要
目的:比较高通量血液透析和常规血液透析的临床疗效。方法:选取接受血液透析治疗的84例患者作为研究对象,根据随机数字法分为对照组和研究组,每组42例。对照组接受常规血液透析治疗,研究组接受高通量血液透析治疗,测定两组患者治疗前后血肌酐、血清尿素氮、血磷、血清全段甲状腺素浓度以及β_2-微球蛋白等指标,计算下降率,并比较并发症发生情况及治疗效果。结果:研究组透析后iPTH、β_2-MG、血磷下降率较对照组高,差异有统计学意义(P<0.05),两组BUN、SCr下降率相比差异无统计学意义(P>0.05);研究组治疗总有效率显著高于对照组,差异有统计学意义(P<0.05);研究组心脏病变、透析中低血压发生率略高于对照组,但差异无统计学意义(P>0.05),透析中高血压、皮肤瘙痒发生率较对照组低,差异有统计学意义(P<0.05)。结论:高通量血液透析可有效清除大分子毒素,减少并发症,提升治疗效果,但需格外注意心脏病变、低血压等并发症发生。
Objective To compare the clinical efficacy of high-flux hemodialysis(HFHD) and conventional hemodialysis(CHD).Method 84 patients with hemodialysis in the hospital were selected,and they were divided into control group and research group by random number table,with 42 cases in each group.Control group was given CHD,while research group was treated with HFHD.The serum creatinine,serum urea nitrogen,serum phosphate,intact parathyroid hormone concentration,β_2-microglobulin of two groups before and after treatment were assessed,and the decreased rate was calculated.The complications and curative effects were compared.Results After dialysis,the decreased rate of iPTH,β_2-MG,serum phosphate in research group were higher than those in control group(P<0.05),and there was no statistical difference in the decreased rate of BUN and Scr between the two groups(P>0.05);The total effective rate of research group was higher than that of control group(P<0.05);The incidence of heart disease and hypotension in research group was slightly higher than that in control group,but there was no statistical difference(P>0.05),and the incidence of hypertension and skin itch in research group was lower than that in control group(P<0.05).Conclusion HFHD can effectively clear away macromolecular toxin,reduce complications and increase curative effect,but it is necessary to pay much attention to heart disease and hypotension.
Objective To compare the clinical efficacy of high-flux hemodialysis(HFHD) and conventional hemodialysis(CHD).Method 84 patients with hemodialysis in the hospital were selected,and they were divided into control group and research group by random number table,with 42 cases in each group.Control group was given CHD,while research group was treated with HFHD.The serum creatinine,serum urea nitrogen,serum phosphate,intact parathyroid hormone concentration,β_2-microglobulin of two groups before and after treatment were assessed,and the decreased rate was calculated.The complications and curative effects were compared.Results After dialysis,the decreased rate of iPTH,β_2-MG,serum phosphate in research group were higher than those in control group(P<0.05),and there was no statistical difference in the decreased rate of BUN and Scr between the two groups(P>0.05);The total effective rate of research group was higher than that of control group(P<0.05);The incidence of heart disease and hypotension in research group was slightly higher than that in control group,but there was no statistical difference(P>0.05),and the incidence of hypertension and skin itch in research group was lower than that in control group(P<0.05).Conclusion HFHD can effectively clear away macromolecular toxin,reduce complications and increase curative effect,but it is necessary to pay much attention to heart disease and hypotension.
引文
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[10] 卓建钦.高通量血液透析在糖尿病肾病长期维持性血液透析患者治疗中对炎性反应及应激反应的影响[J].吉林医学,2018,39(4):659.
[2] 张洪源,林小堃.高通量血液透析联合尿毒清对老年终末期肾病患者细胞免疫的影响[J].实用医学杂志,2018,34(2):272.
[3] 董海霞,吕玉凤.高通量透析对尿毒症患者血液透析炎症因子和脑钠肽的影响[J].中国医师杂志,2016,18(4):532.
[4] 赵景新,张永艳,曾文.不同透析方式治疗糖尿病肾病尿毒症患者效果比较[J].现代中西医结合杂志,2016,25(23):2572.
[5] 陈理境,范德墉,施向东.不同血液净化方式对尿毒症大中分子毒素清除的疗效观察[J].浙江临床医学,2018,20(3):459.
[6] 王静艳,赵伟,薄天慧,等.探讨高通量血液透析对维持性血透患者透析中血压升高的影响[J].中国中西医结合肾病杂志,2016,17(8):712.
[7] 高世洪,刘强,谢聪聪,等.高通量透析对维持性血液透析患者钙磷代谢及血脂影响[J].安徽医学,2017,38(12):1577.
[8] 张文阁,李强,张璐,等.组合人工肾、血液透析滤过、高通量透析对尿毒症脑病患者中大分子毒素清除效果观察[J].陕西医学杂志,2017,46(7):904.
[9] 陈理境,范德墉,施向东.不同血液净化方式对尿毒症患者血液中中、大分子毒素清除的效果比较[J].中国基层医药,2017,24(10):1445.
[10] 卓建钦.高通量血液透析在糖尿病肾病长期维持性血液透析患者治疗中对炎性反应及应激反应的影响[J].吉林医学,2018,39(4):659.