尿毒症患者不同血液净化方式的临床疗效探究
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摘要
目的探究不同血液净化方式对尿毒症患者的临床疗效。方法选取该院2017年6月—2018年6月72例尿毒症患者进行回顾性分析,根据随机数字表的方法,将其划分成普通血液透析组(HD)、血液透析滤过组(HDF)、血液透析联合血液灌流组(HDP),各24例。在此基础上,对各组患者治疗前后的尿毒症毒素血肌酐、β2-微球蛋白、甲状旁腺激素的变化情况进行对比。结果治疗3个月后,HD组的血肌酐、β2-微球蛋白、甲状旁腺激素水平为(954±301.2)mmol/L、(46±13.1)mg/L、(340±142.1)mg/L,HDF组的血肌酐、β2-微球蛋白、甲状旁腺激素水平为(954±326.1)mmol/L、(40±12.3)mg/L、(301±152.3)mg/L,HDP组的血肌酐、β2-微球蛋白、甲状旁腺激素水平为(940±297.6)mmol/L、(36±14.2)mg/L、(294±145.5)mg/L,与HD相比,HDF组与HDP组的血肌酐、β2-微球蛋白、甲状旁腺激素水平显著降低,差异有统计学意义(χ~2=10.625,P=0.0045)。结论不同血液净化方式对尿毒症患者的改善效果不同,血液透析滤过与血液透析联合血液灌流方法对尿毒症患者的改善情况最优,能使病人的生活质量发生变化。
Objective To explore the clinical effect of different blood purification methods on patients with uremia.Methods A retrospective analysis was performed on 72 patients with uremia admitted to our hospital from June 2017 to June 2018. The patients were divided into hemodialysis group(HD), Hemodiafiltration group(HDF), and Hemodialysis combined with hemoperfusion group(HDP), according to the method of random number table. On this basis, the changes of uremia toxin creatinine, β2-microglobulin and parathyroid hormone before and after treatment were compared. Results After 3 months of treatment, serum creatinine, beta 2-microglobulin, and parathyroid hormone levels in the HD group were(954±301.2) mmol/L,(46±13.1) mg/L,(340±142.1) mg/L. In HDF group, the data were(954±326.1)mmol/L,(40±12.3) mg/L,(301±152.3) mg/L respectively. And in the HDP group, the data were(940±297.6)mmol/L,(36±14.2)mg/L,and(294±145.5) mg/L, respectively. The data of HDF and HDP groups were significantly lower than those of HD group,and the difference was statistically significant(χ~2=10.625,P=0.004 5). Conclusion Different blood purification methods have different effects on patients with uremia. Hemodiafiltration and hemodialysis combined with hemoperfusion is the best method to improve the condition of the patients with uremia, which can change patients' quality of life and prolong their survival time. Therefore, the method of hemodiafiltration and hemodialysis combined with hemoperfusion should be widely popularized in clinical practice.
Objective To explore the clinical effect of different blood purification methods on patients with uremia.Methods A retrospective analysis was performed on 72 patients with uremia admitted to our hospital from June 2017 to June 2018. The patients were divided into hemodialysis group(HD), Hemodiafiltration group(HDF), and Hemodialysis combined with hemoperfusion group(HDP), according to the method of random number table. On this basis, the changes of uremia toxin creatinine, β2-microglobulin and parathyroid hormone before and after treatment were compared. Results After 3 months of treatment, serum creatinine, beta 2-microglobulin, and parathyroid hormone levels in the HD group were(954±301.2) mmol/L,(46±13.1) mg/L,(340±142.1) mg/L. In HDF group, the data were(954±326.1)mmol/L,(40±12.3) mg/L,(301±152.3) mg/L respectively. And in the HDP group, the data were(940±297.6)mmol/L,(36±14.2)mg/L,and(294±145.5) mg/L, respectively. The data of HDF and HDP groups were significantly lower than those of HD group,and the difference was statistically significant(χ~2=10.625,P=0.004 5). Conclusion Different blood purification methods have different effects on patients with uremia. Hemodiafiltration and hemodialysis combined with hemoperfusion is the best method to improve the condition of the patients with uremia, which can change patients' quality of life and prolong their survival time. Therefore, the method of hemodiafiltration and hemodialysis combined with hemoperfusion should be widely popularized in clinical practice.
引文
[1]丘洁.2种不同血液净化方式对慢性肾衰竭尿毒症患者体内毒素清除效果比较[J].现代医药卫生,2018(18)2873-2875.
[2]曹新丽,李琦晖.哌拉西林/他唑巴坦致尿毒症患者血小板急剧减少1例[J].检验医学与临床,2018,15(17):2682-2683.
[3]Daisy.The SSR response was used to evaluate the clinical effect of different blood purification methods in the treatment of neuropathy patients with uremi[J].Journal of tropical medicine,2016,11(1):110-112.
[4]钟家浩,黄志勇,黎凤美.不同血液净化方式对尿毒症并发心力衰竭病人疗效及心肌酶水平的影响[J].青岛大学学报:医学版,2018,54(4):407-409,414.
[5]Combs SA,Teixeira JP,Germain MJ.Pruritus in Kidney Disease.Semin Nephrol,2015,35(4):383-391.
[6]Winni.Effects of different dialysis on parathyroid hormone and calcium and phosphorus metabolism in elderly patients with uremia[J].Clinical misdiagnosis and treatment,2018,11(10):12-13.
[7]Crystal.The clinical effect and complications of different blood purification methods on uremia patients were analyzed[J].Modern practical medicine,2017,14(17):80-82.
[8]Abby,Ada.Risk factors and bacterial distribution characteristics of central venous catheter infection in hemodialysis patients with uremia[J].Modern practical medicine,2018,10(16):800-801.
[9]崔晓丽.不同血液净化方式对慢性肾衰竭尿毒症患者血管活性物质的影响[J].中外女性健康研究,2018(14):41-42.
[2]曹新丽,李琦晖.哌拉西林/他唑巴坦致尿毒症患者血小板急剧减少1例[J].检验医学与临床,2018,15(17):2682-2683.
[3]Daisy.The SSR response was used to evaluate the clinical effect of different blood purification methods in the treatment of neuropathy patients with uremi[J].Journal of tropical medicine,2016,11(1):110-112.
[4]钟家浩,黄志勇,黎凤美.不同血液净化方式对尿毒症并发心力衰竭病人疗效及心肌酶水平的影响[J].青岛大学学报:医学版,2018,54(4):407-409,414.
[5]Combs SA,Teixeira JP,Germain MJ.Pruritus in Kidney Disease.Semin Nephrol,2015,35(4):383-391.
[6]Winni.Effects of different dialysis on parathyroid hormone and calcium and phosphorus metabolism in elderly patients with uremia[J].Clinical misdiagnosis and treatment,2018,11(10):12-13.
[7]Crystal.The clinical effect and complications of different blood purification methods on uremia patients were analyzed[J].Modern practical medicine,2017,14(17):80-82.
[8]Abby,Ada.Risk factors and bacterial distribution characteristics of central venous catheter infection in hemodialysis patients with uremia[J].Modern practical medicine,2018,10(16):800-801.
[9]崔晓丽.不同血液净化方式对慢性肾衰竭尿毒症患者血管活性物质的影响[J].中外女性健康研究,2018(14):41-42.