Objective To explore the clinical effect of component artificial kidney (hemoperfusion associated with hemodialysis) combined with orally administered AiXiTe in treating uremic cutaneous pruritus. Methods 40 uremia patients with maintenance he modialysis who were suffered with severe cutaneous pruritus were randomly divided into control group and treatment group,with 20 cases in each group. Except for general treatment with orally administered antihistamine,sedation,as well as externally used anti pruritic drugs,patients of the control group were treated with hemodialysis for 3 times a week,4 hours per time. While the patients of the treatment group were treated on the basis of general treatment with hemodialysis associated with hemoperfusion. Before the hemoperfusion apparatus was connected to dialyzer,the patients were treated with hemodialysis associated with hemoperfusion for 2 hours,then the hemoperfusion apparatus was detached and the patients were treated by hemodialysis alone for another 2 hours. Ev ery week the patients of the treatment group were treated by abovementioned method for 1 time with hemodialysis associated with hemoperfusion,and 2 times with hemodialysis, 4 hours per time. What is more, the patients of the treatment group were further treated with orally administered AiXiTe (Medicinal charcoal tablets) 1.5 g, 3 times per day. Blood calcium (Ca2+) , blood phosphor us (Ps+ ),intact parathyroid hormone (iPTH) ,hemoglobin,serum albumin levels,as well as cutaneous pruritus scores before treat ment and 6 weeks after treatment were recorded. Results Blood Ps+ ,iPTH,as well as cutaneous score of the patients from the treatment group were decreased significantly after treatment as compared with those before treatment (P<0. 05), while biood Ca2+ , Hb and Alb levels after treatment exhibited no statistically significant changes as compared with those before treatment (P!> 0. 05). As for patients of the control group,the blood Ca2+ ,PS+ ,iPTH,Hb, Alb levels as well as cutaneous score after treatment have no statistically significant changes as compared with those before treatment (P>0. 05). There were statistically significant differences in blood Ps+ , iPTH levels and cutaneous pruritus scores after treatment between the 2 groups (P<0. 05) , while no differences in blood Ca2+ ,Hb and Alb levels could be found between the 2 groups after treatment (P>0. 05). Conclusion Compo nent artificial kidney combined with orally administered AiXiTe could treat uremic cutaneous pruritus effectively with mild side effect,we believe that such a treatment is worth clinical promotion.%目的 探讨组合型人工肾(血液透析串联血液灌流)联合口服爱西特治疗尿毒症皮肤瘙痒临床疗效.方法 选择该院行维持性血液透析并出现严重皮肤瘙痒的尿毒症患者40例,随机分为对照组和治疗组,每组20例.对照组在给予口服抗组胺药、镇静及外用止痒药等一般治疗基础上给予每周3次血液透析治疗,每次4 h.治疗组在一般治疗基础上给予血液透析串联血液灌流治疗,灌流器串联在透析器之前,先进行血液透析串联血液灌流治疗2 h,再将灌流器取下继续血液透析治疗2 h,每周行血液透析串联血液灌流治疗1次,血液透析治疗2次,每次4 h,在此治疗基础上联合口服爱西特(药用炭片)1.5 g,每日3次治疗,观察两组治疗前及治疗6周后,血钙(Ca2+)、磷(P3+ )、全段甲状旁腺激素(iPTH)、血红蛋白(Hb)、血清清蛋白(Alb)及皮肤瘙痒评分变化情况.结果 治疗组治疗后血P3+、iPTH、皮肤瘙痒评分下降,与治疗前比较,差异有统计学意义(P<0.05),而血Ca2+、Hb、Alb与治疗前比较,差异无统计学意义(P>0.05).对照组治疗后血Ca2+ 、P3+ 、iPTH、Hb、Alb与皮肤瘙痒评分与治疗前比较,差异无统计学意义(P>0.05).两组患者治疗后血P3+ 、iPTH、皮肤瘙痒评分比较差异有统计学意义(P<0.05);血Ca2+ 、Hb、Alb比较,差异无统计学意义(P>0.05).结论 组合型人工肾联合口服爱西特治疗尿毒症皮肤瘙痒效果明显,不良反应小,该治疗方案值得在临床上推广.
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