肾内腹膜透析治疗尿毒症患者的效果及对其营养状况、生活质量的影响

张余良　朱莉平　阮凯丽

【摘要】 目的：探討持续非卧床腹膜透析（CAPD）在尿毒症患者中的治疗效果及对其营养情况及生活质量的影响。方法：选取2019年1月-2020年1月景德镇市第一人民医院收治的84例尿毒症患者，依据不同透析方式进行分组，使用血液透析（HD）进行治疗的42例患者作为对照组;使用CAPD治疗的42例患者作为研究组。观察比较两组治疗前后的营养状况、生活质量及24 h尿量。结果：治疗前，两组的白蛋白（ALB）、肌酐（Scr）及血红蛋白（Hb）水平比较，差异均无统计学意义（P>0.05）。治疗6个月后，研究组ALB及Hb水平均高于对照组，差异均有统计学意义（P<0.05），研究组Scr水平低于对照组，差异有统计学意义（P<0.05）。治疗前，两组各项生活质量指标评分比较，差异均无统计学意义（P>0.05）;治疗6个月后，研究组各项生活质量指标评分均高于对照组，差异均有统计学意义（P<0.05）。治疗前，两组的24 h尿量比较，差异无统计学意义（P>0.05）;治疗3、6个月后，研究组24 h尿量均高于对照组，差异均有统计学意义（P<0.05）。结论：给予尿毒症患者使用CAPD治疗，可显著改善患者的营养状况，提升生活质量，保护残余肾功能。

【关键词】 尿毒症 持续非卧床腹膜透析 腹膜透析 血液透析 营养状况 生活质量

The Effect of Intrarenal Peritoneal Dialysis in the Treatment of Patients with Uremia and Its Influence on Nutritional Status and Quality of Life/ZHANG Yuliang， ZHU Liping， RUAN Kaili. //Medical Innovation of China， 2021， 18（36）： -145

[Abstract] Objective： To investigate the effect of continuous ambulatory peritoneal dialysis （CAPD） on the nutritional status and quality of life of uremic patients. Method： A total of 84 uremic patients treated in The First People’s Hospital of Jingdezhen from January 2019 to January 2020 were divided into groups according to different dialysis methods， 42 patients treated with hemodialysis （HD） were selected as the control group; 42 patients treated with CAPD were selected as the study group. The nutritional status， the quality of life and 24 h urine volume of the two groups before and after treatment were observed and compared. Result： Before treatment， the levels of ALB， Scr and Hb in the two groups were not statistically differences （P>0.05）. After 6 months of treatment， the levels ALB and Hb in the study group were significantly higher than those of the control group， the differences were statistically significant （P<0.05）， the Scr level of the study group was significantly lower than that of the control group， the difference was statistically significant （P<0.05）. Before treatment， there were no statistically significant differences in the scores of various quality of life indexes between the two groups （P>0.05）; after 6 months of treatment， the score levels of various quality of life indicators in the study group were significantly higher than those in the control group， the differences were statistically significant （P<0.05）. Before treatment， there was no significant difference in 24 h urine volume between the two groups （P>0.05）; after 3 and 6 months of treatment， the 24 h urine volume in the study group were higher than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： CAPD can significantly improve the nutritional status， improve the quality of life and protect the residual renal function of uremic patients.

[Key words] Uremia Continuous ambulatory peritoneal dialysis Peritoneal dialysis Hemodialysis Nutritional status Quality of life

First-author’s address： The First People’s Hospital of Jingdezhen， Jiangxi Province， Jingdezhen 333000， China

doi：10.3969/j.issn.1674-4985.2021.36.034

临床中肾脏疾病发展至终末期之后最终会演变为尿毒症[1]。一旦发展至尿毒症期，患者的肾脏会丧失原有的功能，无法进行正常的排泄，使得体内大量毒素蓄积，进而引发相关性临床综合征[2]。临床中常见的尿毒症临床综合征包括紊乱的酸碱平衡、异常的电解质及水代谢等，情况严重的甚至会诱发相关系统病变，如骨骼系统、神经肌肉系统、消化系统、呼吸道系统及心血管系统等[3]。……