CAJ | 학술논문

目的探讨血液透析过程中不同的血液灌流连接方式对维持性血液透析(MHD)患者肾性骨病疗效的影响及护理.方法以64例MHD合并肾性骨病患者为研究对象,按照随机数字表法分成血液灌流前连接组(简称前连接组)和血液灌流后连接组(简称后连接组),每组32例.记录患者临床指标、生化指标及并发症,比较2种血液灌流连接方式治疗MHD患者肾性骨病的效果.结果后连接组血清全段甲状旁腺激素(iPTH)水平较前连接组低[(133.02±38.63) ng/L比(191.36 ±53.96) ng/L],差异有统计学意义,t=3.517,P＜0.05;后连接组低血压和体外循环凝血发生率明显低于前连接组[8.85％(51/576)比14.93％(86/576)和6.94％(40/576)比15.97％(92/576)],差异有统计学意义,x2=10.149和23.136,P＜0.01.结论后连接式血液灌流能够明显降低MHD合并肾性骨病患者iPTH水平,且后连接方式并发症相对较少,值得临床广泛推广.
목적 탐토혈액투석과정중불동적혈액관류련접방식대유지성혈액투석(MHD)환자신성골병료효적영향급호리.방법 이64례MHD합병신성골병환자위연구대상,안조수궤수자표법분성혈액관류전련접조(간칭전련접조)화혈액관류후련접조(간칭후련접조),매조32례.기록환자림상지표、생화지표급병발증,비교2충혈액관류련접방식치료MHD환자신성골병적효과.결과 후련접조혈청전단갑상방선격소(iPTH)수평교전련접조저[(133.02±38.63) ng/L비(191.36 ±53.96) ng/L],차이유통계학의의,t=3.517,P＜0.05;후련접조저혈압화체외순배응혈발생솔명현저우전련접조[8.85％(51/576)비14.93％(86/576)화6.94％(40/576)비15.97％(92/576)],차이유통계학의의,x2=10.149화23.136,P＜0.01.결론 후련접식혈액관류능구명현강저MHD합병신성골병환자iPTH수평,차후련접방식병발증상대교소,치득림상엄범추엄.
Objective To explore the therapeutic effect and nursing points of different linked modes in hemodialysis combined with hemoperfusion on renal osteopathy disease in maintenance hemodialysis (MHD) patients.Methods Sixty-four MHD patients with renal osteopathy disease were enrolled in the study.They were divided into two groups by random digits table method:the front connection group and the back connection group with 32 cases each.Their clinical data,serum parameters and complications were recorded.The therapeutic effect of two groups were compared.Results The serum level of intact parathyroid hormone(iPTH) was (191.36 ± 53.96) ng/L in the front connection group,while (133.02 ± 38.63) ng/L in the back connection group,and there was significant difference,t=3.517,P＜0.05.The incidence of lower blood pressure and blood coagulation were 8.85％(51/576),6.94％(40/576) in the back connection group,while 14.93％(86/576),15.97％(92/576) in the front connection group,and there were significant differences,x2=10.149,23.136,P＜0.01.Conclusion The back linked mode in hemodialysis combined with hemoperfusion can obviously decrease iP:TH of MHD patients combined with renal osteopathy disease and has less complications,worth clinical promotion.