不同血液净化方式对尿毒症患者透析效果的影响

摘要

目的：观察3种不同血液净化方式[血液透析（HD）、血液透析滤过（HDF）、HD联合血液灌流（HP）]对维持血液透析（MHD）患者高磷血症的清除效果。方法将2013年6月至2014年5月收治的65例MHD患者按透析方案分为HD组（23例）、HDF组（22例）、HD联合HP组（20例），以透析12周为1个疗程，分别检查入选时及透析4、12周各组患者全段甲状旁腺素、血磷、血钙、血肌酐等指标变化。结果透析4、12周后HDF组、HD联合HP组患者血磷显著下降，差异均有统计学意义（P<0.05），两组患者透析后同时间点比较，差异均无统计学意义（P>0.05）；透析后HD组患者血磷无明显变化，差异无统计学意义（P>0.05）。结论 HDF、HD联合HP清除MHD患者高磷效果显著，而HD效果则不佳。%Objective To observe 3 different ways of hemopurification′s[hematodialysis(HD),hemodiafiltration(HDF), HD combining hemoperfusion(HP)] clearing effect on maintaining hematodialysis(MHD) patients′hyperphosphatemia. Methods Divided 65 MHD patients into HD group(n=23),HDF group(n=22),HD combining HP group(n=20) according to dialysis plan. Set 12 weeks as 1 course of dialysis treatment. Examined patients′intact parathyroid hormone,serium inorganic phosphorus,blood calcium,and serum creatinine when they were selected and on 4,12 weeks. Results HDF group and HD combining HP group′s serium inorganic phosphorus notably reduced after 4 and 12 weeks of dialysis ,differences showing statistical significance (P<0.05). Compared 2 groups at the same time after dialysis,differences showing no statistical significance (P>0.05). HD group′s serium inorganic phosphorus had no significant change,differences showing statistical significance(P<0.05). Conclusion Using HDF and HD combining HP can remarkably clear MHD patients′hyperphosphate,while HD has poor effect.