持续性血液透析治疗老年慢性肾衰竭患者的临床疗效及不良反应

周惠

摘要：目的：探討持续性血液透析用于老年慢性肾衰竭治疗中的效果。方法：于2018年1月～2020年12月，选取我院50例老年慢性肾衰竭患者作为研究对象，依据随机数字表法将患者随机分为对照组与观察组各25例。对照组采取间歇性血液透析，观察组采取持续性血液透析，比较两组患者的总有效率、平均尿素清除指数及不良反应发生率，并比较两组患者治疗前、治疗后的血清炎症因子指标、症状评分、肾功能指标、肾脏纤维化指标、睡眠状况指标、生活质量评分。结果：观察组、对照组的总有效率分别为96.00%、84.00%，观察组高于对照组，但差异无统计学意义（P>0.05）。观察组的平均尿素清除指数高于对照组（P<0.05）。治疗后，观察组的CRP、PCT、IL-6、症状评分、血肌酐、尿素氮、纤维连接蛋白、IV型胶原均低于对照组（P<0.05），观察组的内生肌酐清除率高于对照组（P<0.05）。治疗后，观察组的入睡潜伏期短于对照组（P<0.05），观察组的实际睡眠时长长于对照组（P<0.05），观察组的PSQI评分低于对照组（P<0.05），观察组的生活质量评分高于对照组（P<0.05）。不良反应发生率在两组间比较，差异无统计学意义（P>0.05）。结论：持续性血液透析对老年慢性肾衰竭的治疗效果优于间歇性血液透析，可更加有效地控制炎症反应、肾损害，有利于改善睡眠及生活质量，且安全性良好。

关键词：慢性肾衰竭;持续性血液透析;不良反应;疗效;肾功能

【Abstract】Objective：To investigate the effect of continuous hemodialysis in the treatment of elderly chronic renal failure. Methods：From January 2018 to December 2020，50 elderly patients with chronic renal failure in our hospital were selected as the research objects. According to the random number table method，the patients were randomly divided into control group and observation group with 25 cases each. The control group took intermittent hemodialysis，and the observation group took continuous hemodialysis. The total effective rate，average urea clearance index and the incidence of adverse reactions were compared between the two groups of patients，and the serum inflammatory factor indexes of the two groups before and after treatment were compared.，Symptom score，renal function index，renal fibrosis index，sleep status index，quality of life score. Results：The total effective rates of the observation group and the control group were 96.00% and 84.00%，respectively. The observation group was higher than the control group，but the difference was not statistically significant（P>0.05）. The average urea clearance index of the observation group was higher than that of the control group（P<0.05）. After treatment，CRP，PCT，IL-6，symptom score，blood creatinine，urea nitrogen，fibronectin，and type IV collagen in the observation group were lower than those in the control group（P<0.05），and the endogenous creatinine clearance rate in the observation group was high In the control group（P<0.05）. After treatment，the sleep latency of the observation group was shorter than that of the control group（P<0.05），and the actual sleep time of the observation group was longer than that of the control group（P<0.05）. The PSQI score of the observation group was lower than that of the control group（P<0.05）. The score of quality of life was higher than that of the control group（P<0.05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups（P>0.05）. Conclusion：Continuous hemodialysis is better than intermittent hemodialysis in the treatment of chronic renal failure in the elderly. It can more effectively control inflammation and kidney damage，and is beneficial to improve sleep and quality of life，and has good safety.

【Keywords】：chronic renal failure;continuous hemodialysis;adverse reactions;curative effect;renal function

慢性肾衰竭是由多种肾脏疾病导致的肾功能损伤晚期综合征，在患者肾功能发生障碍后其机体内毒素无法完全代谢排出，毒素易出现潴留，严重影响到患者的生命健康，尤其是老年慢性肾衰竭患者。……