论文部分内容阅读
目的探讨血液灌流(HP)联合血液透析(HD)治疗尿毒症的临床效果。方法将维持性血液透析尿毒症患者19例分为两组,联合组9例,采用透析器与爱尔血液灌流器(ZX150型)串联进行治疗,每周血液透析2~3次,血液灌流两周1次;对照组10例,单纯进行血液透析,每周2~3次。均采用肝素抗凝,血流量200~250 ml/min。透析液为碳酸氢盐,流速为500 ml/min。联合组先血液灌流及透析2 h后再单纯透析2 h,治疗前后检测血尿素氮、肌酐、红细胞数、血色素、白细胞数、血小板数及观察临床症状。结果联合组皮肤瘙痒症状6例完全消失,2例明显改善,1例无明显改善,有效率88.9%:对照组全身皮肤瘙痒无明显改善,两组比较差异有统计学意义(P<0.001);联合组的血色素及白细胞增加均显著高于对照组(P<0.01),联合组和对照组治疗前后生化指标改善均显著,两组比较差异无统计学意义。结论血液灌流联合血液透析治疗尿毒症可有效减轻皮肤瘙痒,弥补了单纯血液透析的缺点。
Objective To investigate the clinical effect of hemoperfusion (HP) and hemodialysis (HD) on uremia. Methods Nineteen patients with maintenance hemodialysis uremia were divided into two groups. The combination group consisted of 9 patients. Serum was dialyzed with dialyzer and Aier hemoperfusion (ZX150) Week 1; control group 10 cases, simple hemodialysis, 2 to 3 times per week. Heparin anticoagulation, blood flow 200 ~ 250 ml / min. Dialysate was bicarbonate with a flow rate of 500 ml / min. Combined group first hemodialysis and dialysis 2 h and then dialysis 2 h before and after treatment, blood urea nitrogen, creatinine, red blood cell count, hemoglobin, white blood cell count, platelet count and observed clinical symptoms. Results The skin pruritus in the combination group disappeared completely in 6 cases, 2 cases improved obviously, 1 case had no obvious improvement. The effective rate was 88.9%. There was no significant improvement in pruritus of the control group. There was significant difference between the two groups (P <0.001). The hemoglobin and leukocytosis in the combination group were significantly higher than those in the control group (P <0.01). The biochemical indexes of the combination group and the control group were significantly improved before and after treatment, with no significant difference between the two groups. Conclusion Hemoperfusion combined with hemodialysis treatment of uremia can effectively reduce skin itching, make up for the shortcomings of hemodialysis alone.