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目的:探讨血液灌流联合血液透析治疗尿毒症的临床价值。方法:选取我院2014年5月~2016年4月接收血液透析的尿毒症患者90例,全部患者均采用血液透析进行维持性治疗,将其分为对照组(45例)与治疗组(45例)两组。对照组进行单纯的血液透析,而治疗组则在血液透析的基础上联合血液灌流进行治疗。观察和比较两组患者治疗前后血清肌酐(Cr)、β2微球蛋白(β2-MG)、血液尿素氮(BUN)、甲状旁腺激素(PTH)、球蛋白、白蛋白、血常规、电解质的变化情况以及治疗后临床症状的改善情况。结果:治疗前,两组患者的血清Cr、β2-MG、BUN、PTH水平比较差异无统计学意义(P>0.05);治疗后,治疗组患者的血清β2-MG、PTH水平较治疗前明显下降(P<0.05),对照组患者各项指标无明显变化(P>0.05)。两组患者治疗前后的球蛋白、白蛋白、血常规、电解质均无明显变化。治疗后,治疗组的临床不良反应改善率明显高于对照组(P<0.05)。结论:与单纯的血液透析相比,血液灌注联合血液透析能够更有效清除尿毒症患者体内Cr、β2-MG、BUN、PTH的蓄积,改善不良反应,且不会引起球蛋白、白蛋白、血常规、电解质的变化而破坏内平衡。
Objective: To investigate the clinical value of hemoperfusion combined with hemodialysis in the treatment of uremia. Methods: Totally 90 uremic patients receiving hemodialysis from May 2014 to April 2016 in our hospital were enrolled in this study. All of them were treated by hemodialysis for maintenance therapy, which were divided into control group (45 cases) and treatment group (45 cases) Example) Two groups. The control group received simple hemodialysis, while the treatment group received hemodialysis on the basis of hemodialysis. The levels of serum creatinine (Cr), β2-MG, BUN, PTH, globulin, albumin, blood and electrolyte Changes and the improvement of clinical symptoms after treatment. Results: Before treatment, serum Cr, β2-MG, BUN and PTH in two groups had no significant difference (P> 0.05); after treatment, serum β2-MG and PTH levels in the treatment group were significantly higher than those before treatment (P <0.05). There was no significant change in each index in the control group (P> 0.05). The two groups of patients before and after treatment of globulin, albumin, blood, electrolytes were no significant changes. After treatment, the improvement rate of clinical adverse reactions in the treatment group was significantly higher than that in the control group (P <0.05). Conclusion: Compared with simple hemodialysis, hemoperfusion combined with hemodialysis can effectively remove the accumulation of Cr, β2-MG, BUN and PTH in uremic patients and improve adverse reactions without causing globulin, albumin, blood Conventional, electrolyte changes and destroy the internal balance.