低通量血液透析串联血液灌流治疗终末期肾脏病的疗效评价

张卓

【摘要】 目的 探讨低通量血液透析串联血液灌流治疗终末期肾脏病的临床疗效。方法 70例终末期肾脏病患者， 随机分为对照组与实验组， 每组35例。两组患者均进行药物治疗， 在此基础上， 对照组患者采用常规血液透析， 实验组患者采用低通量血液透析串聯血液灌流治疗。比较两组患者治疗前后血钙、血磷、血清β2微球蛋白、血清前白蛋白水平及生活质量评分。结果 治疗前， 两组血钙、血磷、血清β2微球蛋白、血清前白蛋白水平比较差异无统计学意义（P>0.05）。治疗后， 两组血钙水平比较差异无统计学意义（P>0.05）;两组血磷、血清β2微球蛋白及血清前白蛋白水平均优于治疗前， 且实验组优于对照组， 差异具有统计学意义（P<0.05）。治疗前， 对照组与实验组生活质量评分分别为（62.14±13.21）、（63.15±15.32）分;治疗后， 对照组与实验组生活质量评分分别为（69.71±24.75）、（76.98±25.69）分;治疗前， 两组生活质量评分比较比较， 差异无统计学意义（P>0.05）;治疗后， 两组生活质量评分均高于治疗前， 且实验组高于对照组， 差异有统计学意义（P<0.05）。结论 终末期肾脏病患者采用低通量血液透析串联血液灌流治疗， 临床疗效显著提高， 可有效改善患者治疗后的各项生理指标， 具有较高的临床价值。

【关键词】 低通量血液透析;血液灌流;终末期肾脏病

DOI：10.14163/j.cnki.11-5547/r.2020.13.009

Evaluation of the efficacy of low-flux hemodialysis combined with hemoperfusion in the treatment of end-stage renal disease   ZHANG Zhuo. Urology Department， Shenzhen Pingshan District Peoples Hospital， Shenzhen 518118， China

【Abstract】 Objective   To discuss the clinical efficacy of low-flux hemodialysis combined with hemoperfusion in the treatment of end-stage renal disease. Methods   A total of 70 patients with end-stage renal disease were randomly divided into control group and experimental group， with 35 cases in each group. The patients in both groups were treated with drugs. Patients in the control group were treated with routine hemodialysis， and patients in the experimental group were treated with low-flux hemodialysis combined with hemoperfusion. The levels of blood calcium， blood phosphorus， serum β2 microglobulin， serum prealbumin and quality of life score before and after treatment were compared between the two groups. Results   Before treatment， there was no statistically significant difference in levels of blood calcium， blood phosphorus， serum β2 microglobulin， serum prealbumin between the two groups （P>0.05）. After treatment， there was no statistically significant difference in blood calcium level between the two groups （P>0.05）. The levels of blood phosphorus， serum β2 microglobulin and serum prealbumin in the two groups were better than those before treatment of the same group， and the experimental group was better than that of the control group. The difference was statistically significant （P<0.05）. Before treatment， the quality of life score of the control group and experimental group were （62.14±13.21） and （63.15±15.32） points， which were （69.71±24.75） and （76.98±25.69） points after treatment. Before treatment， there was no statistically significant difference in quality of life score between the two groups （P>0.05）. After treatment， the quality of life score of the two groups were higher than those before treatment， and the experimental group was higher than the control group. The difference was statistically significant （P<0.05）. Conclusion   Low-flux hemodialysis combined with hemoperfusion shows remarkable clinical efficacy in the treatment of patients with end-stage renal disease， and it can effectively improve the physiological indicators of patients after treatment， thus it has a high clinical value.

【Key words】 Low-flux hemodialysis; Hemoperfusion; End-stage renal disease

临床上常用血液透析的方法治疗终末期肾脏病， 是临床上最常用的血液净化方法之一[1]， 近年来， 由于人工合成的透析膜大量且快速的发展， 促进临床上血液透析技术的日益成熟[2]， 越来越多的血液透析新模式在临床上取得成功并广泛应用于肾脏病患者， 如高效能透析、低通量透析、高通量透析等。对于终末期肾脏病患者来说， 单纯的血液透析不能彻底清除体内的尿毒症毒素， 其中对于终末期肾脏病患者采用血液灌流的治疗方法临床效果显著， 血液灌流通常指对患者体内血液进行体外吸附， 将富含吸附中分子溶质的治疗仪器应用于终末期肾脏病患者的治疗中， 是临床上最常见的体外吸附方法之一[3]。多项研究……