血液透析滤过联合血液灌流治疗尿毒症继发甲状旁腺功能亢进患者的疗效

段思宇

血液透析滤过联合血液灌流治疗尿毒症继发甲状旁腺功能亢进患者的疗效

段思宇

目的 探讨血液透析滤过与血液灌流治疗尿毒症继发甲状旁腺功能亢进患者的临床疗效。方法 选取2014年3月至2016年1月东莞市中医院收治的尿毒症继发甲状旁腺功能亢进患者78例为研究对象，按随机数字表法分为观察组与对照组，每组39例。对照组患者单纯行血液透析，观察组患者采用血液透析滤过与血液灌流联合治疗，比较两组患者治疗前后甲状旁腺素、血尿素、血清钙、血肌酐、血磷、血红蛋白及红细胞压积。结果 两组患者末次治疗前血红蛋白、促红素用量及红细胞压积比较，差异均有统计学意义（均P＜0.05）；两组患者首、末次治疗后血尿素、血肌酐、血清钙及血磷比较，差异均有统计学意义（均P＜0.05）；两组患者首次治疗后及末次治疗前后甲状旁腺素比较，差异有统计学意义（P＜0.05）。结论 血液透析滤过联合血液灌流应用于尿毒症继发甲状旁腺功能亢进患者的临床治疗可以更彻底地清除尿毒症继发甲状旁腺功能亢进患者体内的毒素，从而实现对慢性肾功能衰竭并发症的有效预防及治疗。

尿毒症；甲状旁腺功能亢进；血液透析滤过；血液透析；血液灌流

【Abstract】Objective To investigate the hemodiafiltration and hemoperfusion uremia secondary hyperparathyroidism in patients with clinical efficacy.Methods March 2014 to January 2016，Dongguan City Hospital treated uremic secondary hyperparathyroidism in 78 patients for the study，were randomly divided into observation group and control group 39 cases.The control group of patients mere hemodialysis，the observation group were treated with hemoperfusion and hemodiafiltration combination therapy，two groups of patients before and after parathyroid hormone，blood urea nitrogen，serum calcium，serum creatinine， phosphorus， hemoglobin and hematocrit.Results There were before the last treatment hemoglobin，the amount of erythropoietin and hematocrit，the difference was statistically significant（P＜0.05）；the first two groups of patients，blood urea， serum creatinine，serum calcium and serum after the last treatment phosphorus，the difference was statistically significant（P＜0.05）；parathyroid hormone before and after treatment，and the last two groups of patients after initial treatment，the difference was statistically significant（P＜0.05）.Conclusion Hemodiafiltration combined with hemoperfusion applied uremia secondary hyperparathyroidism in patients with clinical treatment can be more thorough purge of secondary hyperparathyroidism in patients with uremic toxins，enabling the complications of chronic renal failure the effective prevention and treatment.

【Key words】Uremia；Parathyroid function；Blood dialysis filtration；Hemodialysis；Blood perfusion

继发性甲状旁腺功能亢进是尿毒症的常见并发症，甲状旁腺增生、甲状旁腺激素分泌增加是本病的主要临床表现。尿毒症患者随着血液透析时间延长，各类大分子毒素不断聚集于体内，相关并发症不断发展也对患者的生命质量产生严重影响，主要继发疾病包括淀粉变样与甲状旁腺功能亢进［1］。……