血液灌流联合血液透析治疗尿毒症皮肤瘙痒临床观察.docVIP

血液灌流联合血液透析治疗尿毒症皮肤瘙痒临床观察[摘要] 目的：探讨血液灌流联合血液透析治疗尿毒症的临床疗效。方法：维持性血液透析患者24例，随机分为两组，治疗组12例，采用血液灌流联合透析治疗；对照组12例，单纯透析治疗。两组均采用肝素抗凝，血流量200～250 ml/min，透析液流量500 ml/min。检测治疗前后血肌酐、尿素氮、甲状旁腺激素、β2微球蛋白、血压及临床症状。结果：治疗组皮肤瘙痒减轻及甲状旁腺激素、β2微球蛋白清除显著高于对照组（P＜0.05）。结论：血液灌流联合血液透析治疗尿毒症病人，可清除中分子物质，可有效减轻皮肤瘙痒。 [关键词] 血液灌流；血液透析；尿毒症 [中图分类号]R589[文献标识码]A [文章编号]1673-7210（2008）04（a）-042-02 Clinical study of treating skin pruritus caused by uremia by hemoperfusion combined with hemodialysis DANG Yong, XIE Quan-kun （Department of Nephrology, The people’s Hospital of Anyang， Anyang 455000,China） [Abstract] Objective:To study the effect of hemoperfusion(HP) combined with hemodialysis(HD) on the patients with uremia. Methods:24 maintenance hemodialysis patients were randomly divided into the test group(n=12) and control group(n=12). The hemoperfusion connected with hemodialysis in series was used in the test group and the hemodialysis in the control group. Anticoagulant is heparin. The hemodialysis blood flow rate was 200~250 ml/min, dialysate flow rate was 500ml/min. The time of pruritus relief and the level of SCr、BUN、PTH、β2-MG in the blood were measured before and after treatment. Results:The relief of skin itching and the clearance ofPTH and β2-MG were significantly higher in the test group than the control group（P＜0.05）.Conclusion: The treatment of hemoperfusion connected with hemodialysis in series can effectively relieve skin pruritus and clean the middle-large molecular substance. [Key words] Hemoperfusion;Hemodialysis;Uremia 各种原因导致的慢性肾功能衰竭发生率逐年增加，血液透析是治疗尿毒症的有效方法之一，随着维持性血透患者生存期的不断延长，许多透析相关的并发症不断出现。皮肤瘙痒是慢性肾衰竭常见的症状之一，发生率为36.1％，单纯透析治疗可增加瘙痒发生率约60％～90％[1]，虽不直接威胁生命，但严重影响患者的生活。我院血透中心2005年8月～2007年9月采用血液灌流（HP）联合血液透析（HD）治疗尿毒症皮肤瘙痒12例，取得满意疗效，现报道如下： 1 资料与方法 1.1 一般资料 我院血透中心2005年8月～2007年9月长期透析患者24例，透析时间15～50个月；其中，男14例，女10例，平均年龄（42±8）岁。原发病：慢性肾小球肾炎13例，糖尿病肾病5例，高血压肾硬化3例，慢性间质性肾炎2例，梗阻性肾病1例，均符合尿毒症诊断标准。所有患者规律透析3个月以上，每周3次，透析12～24个月，出现全身皮肤瘙痒症状。 1.2 实验分组 上述患者随机分为两组，每组12例：①治疗组行HP与HD串联治疗，灌流器为廊坊