血液透析滤过联合血液灌流对治疗顽固性尿毒症患者皮肤瘙痒的临床探讨

摘要

目的：探讨血液透析滤过联合血液灌流对治疗顽固性尿毒症患者皮肤瘙痒的临床效果。方法将维持性血液透析皮肤瘙痒患者60例随机分成治疗组与对照组各30例，治疗组采用血液透析滤过＋血液灌流，每周2次普通血液透析，1次血液灌流＋血液透析滤过，各2 h ，共4 h；对照组为普通血液透析组，每周3次，4 h／次；共观察10周。比较两组治疗前后血清甲状旁腺激素（ PTH）、β2微球蛋白（β2－MG）浓度及皮肤瘙痒程度。结果治疗组治疗结束后血清中PTH、β2－MG浓度较治疗前明显降低，皮肤瘙痒明显缓解（ P＜0．05）。对照组无明显差异（P＞0．05）。结论血液透析滤过联合血液灌流可以明显缓解维持性血液透析患者皮肤瘙痒症，值得临床推广。%Objective To investigate the clinical effects of hemodiafiltration combined with hemoperfusion in the treatment of pruritus in maintenance hemodialysis patients.Methods Sixty maintenance hemodialysis patients with pruritus were randomly divided into treatment group(n=30) and control group(n=30).The treatment group was treated with hemodiafiltration combined with hemoperfusion, ordinary hemodialysis 2 times a week, hemoperfu-sion combined with hemodiafiltration once, each 2 hours, a total of 4 hours;the control group received ordinary he-modialysis, 3 times a week, every 4 hours;the observations continued 10 weeks.Serum concentrations of PTH,β2-MG in the two groups were observed before and after treatment;And the degree of pruritus were compared.Results After treatment, both the serum PTH andβ2-MG concentration in treatment group was significantly lower than before treatment;pruritus was relived ( P<0.05 ) .No significant differences were found in above indexes in the control group before and after treatment(P>0.05).Conclusion Hemodiafiltration combined with hemoperfusion can signif-icantly alleviate hemodialysis patients′pruritus.