目的：探讨腹膜透析联合血液透析治疗终末期肾病的作用。方法：选择2012年5月-2014年5月于本院住院的诊断为终末期肾病的患者90例作为研究对象。将其分为联合组、腹膜透析组和血液透析组三组，每组30例。随访1年，观察三组患者住院期间的各项生化指标、并发症发生情况，并统计所有患者一年内的生存率和死亡原因，并根据KDQOL-SFTM 1.2生存质量评分表对存活患者的生存质量进行分析。结果：联合组患者血钾、血糖水平与腹膜透析组和血液透析组比较差异无统计学意义（P>0.05）；联合组尿素氮和肌酐水平与血液透析组比较差异无统计学意义（P>0.05），与腹膜透析组比较明显降低，差异有统计学意义（P<0.05）；联合组血红蛋白和白蛋白水平明显高于腹膜透析组和血液透析组，差异有统计学意义（P<0.05），腹膜透析组和血液透析组之间比较差异无统计学意义（P>0.05）。联合组患者并发症总发生率明显少于腹膜透析组和血液透析组，差异有统计学意义（P<0.05），腹膜透析组的并发症发生率高于血液透析组，两组比较差异有统计学意义（P<0.05）。联合组患者生存率明显高于腹膜透析组合血液透析组，差异有统计学意义（P<0.05），腹膜透析组的生存率低于血液透析组，但两组比较差异无统计学意义（P>0.05）。联合组患者症状与不适12项、日常生活的影响8项、工作状况2项、社交质量3项、性功能2项、社会功能2项、精力状况4项较腹膜透析组和血液透析组有明显改善，差异有统计学意义（P<0.05），其中血液透析组得分高于腹膜透析组，两组比较差异有统计学意义（P<0.05）。联合组患者疼痛2项得分明显少于腹膜透析组和血液透析组，差异有统计学意义（P<0.05），但腹膜透析组和血液透析组之间比较差异无统计学意义（P>0.05）。结论：联合透析能够稳定患者的内环境状态，效果好，并发症少，值得临床推广应用。%Objective:To investigate the therapeutic effect of combination of peritoneal dialysis and hemodialysis for end-stage renal disease.Method: 90 patients of end-stage renal disease were selected in our hospital as the research object from May 2012 to May 2014 and divided into three groups,combination group, peritoneal dialysis group and hemodialysis group, 30 cases in each group. One year follow-up,the three groups of patients’ complications , biochemical indexes during hospitalization,and statistics of all patients with in one year survival rate and cause of death were observed, according to the quality of life of 1.2 KDQOL-SFTM scores of quality life on the survival of patients with analysis.Result:There were not statistically significant differences between combination group and peritoneal dialysis group and hemodialysis group in serum potassium and blood glucose level(P>0.05). The combination group of urea nitrogen and creatinine levels compared with hemodialysis group had no significant difference(P>0.05),and compared with peritoneal dialysis group significantly decreased, the difference was statistically significant(P<0.05).Combination group of hemoglobin and albumin levels were significantly higher than that of peritoneal dialysis group and hemodialysis group, the differences were statistically significant(P< 0.05), between peritoneal dialysis group and hemodialysis group had no significant difference (P>0.05).The rate of complication in the combination group was significantly less than peritoneal dialysis group and hemodialysis group,the difference was statistically significant(P< 0.05),peritoneal dialysis group complication rate was higher than the hemodialysis group, there was significant difference between two groups (P<0.05).Combination group of the survival rate of the patients was significantly higher than that of peritoneal dialysis group and hemodialysis group, the difference was statistically significant(P<0.05), peritoneal dialysis group of the survival rate was lower than the hemodialysis group, but the difference had no statistical significance (P>0.05).The combination group patients symptoms and discomfort of 12 items, affect daily life of 8 items, the working condition of 2 items, 3 items of social quality, function of 2 items,social function of 2 items, the energy status of 4 items were better than peritoneal dialysis group and hemodialysis group, the differences were statistically significant(P<0.05), in which the blood dialysis group scored higher than peritoneal dialysis group, there was not significant difference between two groups (P<0.05). The combination group 2 scores of pain was significantly less than peritoneal dialysis group and hemodialysis group, the difference was statistically significant(P<0.05), but between peritoneal dialysis group and hemodialysis group was no statistical significance difference(P>0.05).Conclusion: The combination group patients can stable internal environment condition, good effect, less complications,and it is worthy of clinical application.
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