CAJ | 학술논문

目的观察血液透析联合血液灌流及护理干预对尿毒症继发甲状旁腺功能亢进的治疗效果.方法将50例尿毒症继发甲状旁腺功能亢进患者随机分为常规血液透析组(A组)、血液透析联合血液灌流组(B组);两组均予一系列护理干预,A组予常规透析每周2～3次,B组在常规透析基础上,每周予血液灌流1次,比较两组患者治疗前及治疗30周后血清钙(Ca)、磷(P)和血清全段反应性甲状旁腺激素(iPTH)的浓度;观察两组患者皮肤瘙痒、重症肌无力等症状的改善.结果 B组血清iPTH、血磷的下降较A组差异有统计学意义(P＜0.01);血钙显著上升(P＜0.01);皮肤瘙痒、重症肌无力等症状明显改善.结论血液透析联合血液灌流及护理干预可显著降低患者iPTH水平,改善尿毒症继发甲状旁腺功能亢进引起临床症状.
목적 관찰혈액투석연합혈액관류급호리간예대뇨독증계발갑상방선공능항진적치료효과.방법 장50례뇨독증계발갑상방선공능항진환자수궤분위상규혈액투석조(A조)、혈액투석연합혈액관류조(B조);량조균여일계렬호리간예,A조여상규투석매주2～3차,B조재상규투석기출상,매주여혈액관류1차,비교량조환자치료전급치료30주후혈청개(Ca)、린(P)화혈청전단반응성갑상방선격소(iPTH)적농도;관찰량조환자피부소양、중증기무력등증상적개선.결과 B조혈청iPTH、혈린적하강교A조차이유통계학의의(P＜0.01);혈개현저상승(P＜0.01);피부소양、중증기무력등증상명현개선.결론 혈액투석연합혈액관류급호리간예가현저강저환자iPTH수평,개선뇨독증계발갑상방선공능항진인기림상증상.
Objective To observe the efficacy of hemodialysis and hemoperfusion and nursing intervention for uremic secondary hyperparathyroidism.Methods 50 uremic patients with secondary hyperparathyroidism were collected and randomly divided into a hemodialysis group (group A) and a hemodialysis and hemoperfusion group (group B).Both groups were treated with a series of nursing interventions.Group A were treated with dialysis 2 to 3 times per week,group B with dialysis and hemoperfusion once a week.Serum calcium phosphorus (P) and serum parathyroid hormone reactivity whole paragraph (iPTH) concentration are compared before and after the treatment.Improvements were observed in patients with skin itching and myasthenia gravis.Results Serum iPTH and serum phosphate decreased more significantly(P ＜0.01),calcium increased more significantly (P ＜0.01),and skin itching and myasthenia gravis symptoms improved more significantly in group B than in group A.Conclusions Hemodialysis and hemoperfusion and nursing intervention can significantly reduce iPTH levels in patients with secondary hyperparathyroidism and improve the clinical symptoms caused by uremia.