目的研究血液灌流联合血液透析治疗慢性心肾综合征维持性透析合并顽固性低血压的临床效果。方法 100例慢性心肾综合征维持性透析合并顽固性低血压患者,随机分为透析组和透析+灌流组,各50例。透析组单纯给予血液透析治疗,透析+灌流组给予血液灌流联合血液透析治疗。观察治疗2、4、8、13周低血压发生率及治疗前和治疗13周患者收缩压和舒张压的差异。结果治疗前两组收缩压和舒张压比较差异无统计学意义(P>0.05);治疗13周时两组收缩压和舒张压均显著高于治疗前,且透析+灌流组高于透析组,差异有统计学意义(P<0.05)。两组治疗2周时低血压发生率比较,差异无统计学意义(P>0.05);透析+灌流组治疗4、8、13周时低血压发生率分别为60.00%、50.00%、20.00%,均低于透析组的80.00%、72.00%、60.00%,差异有统计学意义(P<0.05)。结论血液灌流联合血液透析治疗慢性心肾综合征维持性透析合并顽固性低血压的临床效果确切,可有效降低低血压发生率,改善患者血压水平,对患者预后有益,值得推广。 Objective To study the clinical effect of hemoperfusion combined with hemodialysis on maintenance hemodialysis combined with intractable hypotension in patients with chronic renal syndrome. Methods One hundred patients with chronic heart-kidney syndrome who underwent maintenance hemodialysis combined with refractory hypotension were randomly divided into dialysis group and dialysis + perfusion group, 50 cases each. Dialysis group was given hemodialysis only, dialysis + perfusion group was given hemoperfusion and hemodialysis treatment. The incidence of hypotension at 2, 4, 8 and 13 weeks after treatment and the systolic and diastolic blood pressure before and 13 weeks after treatment were observed. Results There was no significant difference in systolic pressure and diastolic pressure between the two groups before treatment (P> 0.05). The systolic and diastolic blood pressures of the two groups were significantly higher than those before treatment at 13 weeks of treatment, The difference was statistically significant (P <0.05). There was no significant difference in the incidence of hypotension between the two groups at 2 weeks (P> 0.05). The hypotensive rates at 4, 8 and 13 weeks after dialysis and perfusion group were 60.00%, 50.00% and 20.00%, respectively Were lower than dialysis group 80.00%, 72.00%, 60.00%, the difference was statistically significant (P <0.05). Conclusion The combination of hemoperfusion and hemodialysis for maintenance hemodialysis with refractory chronic hypotension has the exact clinical effect, which can effectively reduce the incidence of hypotension and improve the blood pressure level of patients, which is worthy of promotion.