高通量血液透析联合应用醋酸钙对高磷血症疗效探讨.docVIP

高通量血液透析联合应用醋酸钙对高磷血症疗效探讨 　　[摘要] 目的 探讨在高磷血症换这种采用高通量血液透析联合应用醋酸钙的临床效果。 方法 方便选取该院2015年2月―2017年2月收治的60例维持性血液透析尿毒症患者，随机分为两组，对照组30例，采用低通量血液透析方法，治疗组30例，采用高通量血液透析联合应用醋酸钙治疗方法，观察两组患者的血磷浓度，血β2-MG浓度和好转率。结果 在经过治疗后发现对照组的血磷浓度为（2.04±1.02）μmol/L，治疗组的血磷浓度为（1.26±0.24）μmol/L，治疗组的血磷浓度在治疗后显著低于对照组（P0.05）。对照组在治疗后的血β2-MG浓度为（18.80±10.10）mg/L ，治疗组的血β2-MG浓度为（5.80±3.20）mg/L，其中治疗组和对照组在治疗前的浓度相似，在治疗后发现治疗组的浓度显著低于对照组（P0.05）。治疗组在治疗后顽固性皮肤瘙痒方面好转率为80%，周围神经病变好转率为70%，慢性骨痛???转率为60%，睡眠改善好转率为85%。对照组中顽固性皮肤瘙痒好转率为15%，周围神经病变的好转率为15%，慢性骨痛好转率为0%，睡眠改善方面好转的好转率为20%。其中治疗组在以上4个症状方面好转率均明显高于对照组（P0.05）。在顽固性皮肤瘙痒、周围神经病变、慢性骨痛和睡眠改善方面治疗组的好转率均明显高于对照组（P0.05）。结论 在高磷血症中采用高通量血液透析联合醋酸钙治疗方法可以明显改善临床症状，提高治疗效果，具有较高的临床治疗价值，值得在临床上应用和推广。 　　[关键词] 高通量血液透析；醋酸钙；高磷血症；临床疗效 　　[中图分类号] R692 [文献标识码] A [文章编号] 1674-0742（2017）12（a）-0071-03 　　[Abstract] Objective To study the clinical effect of high-flux hemodialysis and calcium acetate in hyperphosphatemia. Methods 60 cases of patients with maintenance hemodialysis uremia patients in our hospital from February 2015 to February 2017 were conveniently selected and randomly divided into two groups with 30 cases in each， the control group were treated with low-flux hemodialysis， while the treatemtn group were treated with high-flux hemodialysis and calcium acetate， and the serum inorganic phosphorus concentration， serum β2-MG concentration and improvement rate of the two groups were observed. Results After treatment， the serum inorganic phosphorus concentration was obviously lower than that in the control group， [（2.04±1.02）μmol/L vs （1.26±0.24）μmol/L]（P0.05）， and the difference was obvious， and the serum β2-MG concentration of the two groups was similar before treatment， however， the concentration in the treatment group was obviously lower than that in the control group（P0.05）， and the difference was obvious， and the improvement rates of refractory skin itching pruritus， peripheral neuropathy， chronic hieralgia and sleep in the treatment group were obviously higher than those in the control group，（80%，