CAJ | 학술논문

目的：观察评价单纯血液透析(HD﹚、血液透析联合血液灌流(HD+HP﹚、血液透析联合透析滤过(HDF﹚三种不同血液净化方式对尿毒症患者的临床疗效。方法选取2011年1月~2014年5月我院收治的90例尿毒症患者为研究对象。将90例患者随机分为单纯血液透析(HD﹚组、血液透析联合血液灌流(HD+HP﹚组及血液透析联合透析滤过(HDF﹚组,每组30例,分别采取对应的血液净化疗法。两个月后对治疗前后各组血中毒素水平及皮肤瘙痒症状改善情况进行比较。结果治疗前三组的Pi、Scr及BUN水平均无显著性差异(P>0.05﹚,治疗后各组Pi、Scr及BUN水平较治疗前均有显著下降(P<0.05﹚,三组间各指标相比无显著性差异(P>0.05﹚。治疗前三组PTH、β2-MG及Cys C水平均无显著性差异(P>0.05﹚,治疗后HD组各指标水平较治疗前无显著变化(P>0.05﹚,(HD+HP﹚组、HDF组各指标水平较治疗前明显降低(P<0.05﹚；组间多重比较结果显示治疗后(HD+HP﹚组、HDF组的各项指标水平均低于HD组(P<0.05﹚,但两组间并未见显著差异(P>0.05﹚。治疗(HD+HP﹚组、HDF组皮肤瘙痒症状的改善率均高于HD组(P<0.05﹚,但(HD＋HP﹚组、HDF组组间比较改善率无显著差异(P>0.05﹚。结论 HD、(HD+HP﹚与HDF对小分子物质的清除作用大致相同,(HD+HP﹚与HDF对大、中分子物质的清除效果均优于HD,其中以(HD＋HP﹚效果最佳。
목적：관찰평개단순혈액투석(HD﹚、혈액투석연합혈액관류(HD+HP﹚、혈액투석연합투석려과(HDF﹚삼충불동혈액정화방식대뇨독증환자적림상료효。방법선취2011년1월~2014년5월아원수치적90례뇨독증환자위연구대상。장90례환자수궤분위단순혈액투석(HD﹚조、혈액투석연합혈액관류(HD+HP﹚조급혈액투석연합투석려과(HDF﹚조,매조30례,분별채취대응적혈액정화요법。량개월후대치료전후각조혈중독소수평급피부소양증상개선정황진행비교。결과치료전삼조적Pi、Scr급BUN수평균무현저성차이(P>0.05﹚,치료후각조Pi、Scr급BUN수평교치료전균유현저하강(P<0.05﹚,삼조간각지표상비무현저성차이(P>0.05﹚。치료전삼조PTH、β2-MG급Cys C수평균무현저성차이(P>0.05﹚,치료후HD조각지표수평교치료전무현저변화(P>0.05﹚,(HD+HP﹚조、HDF조각지표수평교치료전명현강저(P<0.05﹚；조간다중비교결과현시치료후(HD+HP﹚조、HDF조적각항지표수평균저우HD조(P<0.05﹚,단량조간병미견현저차이(P>0.05﹚。치료(HD+HP﹚조、HDF조피부소양증상적개선솔균고우HD조(P<0.05﹚,단(HD＋HP﹚조、HDF조조간비교개선솔무현저차이(P>0.05﹚。결론 HD、(HD+HP﹚여HDF대소분자물질적청제작용대치상동,(HD+HP﹚여HDF대대、중분자물질적청제효과균우우HD,기중이(HD＋HP﹚효과최가。
Objective To observe and evaluate the clinical effect of pure hemodialysis (HD﹚, hemodialysis combined with hemoperfusion (HD+HP﹚, hemodialysis combined with hemodiafiltration (HDF﹚ on onuremic patients. Methods All 90 patients with uremic in our hospital from January 2011 to May 2014 were randomly divided into HD group, (HD+HP﹚ group,HDF group according to the treatment methods, 30 cases in each group. After two months,the skin itching symptoms and blood toxin levels before and after treatment in each group of were compared. Results Before treatment,Pi, Scr and BUN levels were not significantly different between groups(P>0.05﹚. After treatment the Pi, Scr and BUN levels were significantly decreased compared with those before treatment(P<0.05﹚. No significant differences between groups(P>0.05﹚. Before treatment,three groups of PTH, β2-MG and Cys C level had no significant difference (P>0.05﹚.After treatment,three groups of PTH,β2-MG and Cys C levels were significantly decreased than before treat-ment(P<0.05﹚.Multiple comparisons between groups showed that the indexes of the level of (HD+HP﹚group was lower than that of the other two groups (P<0.05﹚.(HD+HP﹚ group,HDF group of skin pruritus symptom improvement rate were higher than those in HD group (P<0.05﹚,but (HD+HP﹚groups, HDF groups had no significant difference (P>0.05﹚. Conclusion Scavenging effects of HD,(HD+HP﹚and HDF to the small molecules are roughly the same,but scavenging effect of(HD+HP﹚and HDF for large, middle molecular substances are better than those of HD,so (HD+HP﹚ has the best effect.