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目的探讨血液透析滤过与血液灌流治疗尿毒症继发甲状旁腺功能亢进患者的临床疗效。方法选取2014年3月至2016年1月东莞市中医院收治的尿毒症继发甲状旁腺功能亢进患者78例为研究对象,按随机数字表法分为观察组与对照组,每组39例。对照组患者单纯行血液透析,观察组患者采用血液透析滤过与血液灌流联合治疗,比较两组患者治疗前后甲状旁腺素、血尿素、血清钙、血肌酐、血磷、血红蛋白及红细胞压积。结果两组患者末次治疗前血红蛋白、促红素用量及红细胞压积比较,差异均有统计学意义(均P<0.05);两组患者首、末次治疗后血尿素、血肌酐、血清钙及血磷比较,差异均有统计学意义(均P<0.05);两组患者首次治疗后及末次治疗前后甲状旁腺素比较,差异有统计学意义(P<0.05)。结论血液透析滤过联合血液灌流应用于尿毒症继发甲状旁腺功能亢进患者的临床治疗可以更彻底地清除尿毒症继发甲状旁腺功能亢进患者体内的毒素,从而实现对慢性肾功能衰竭并发症的有效预防及治疗。
Objective To investigate the clinical effects of hemodiafiltration and hemoperfusion on patients with secondary hyperparathyroidism of uremia. Methods From March 2014 to January 2016, Dongguan City Hospital of Chinese medicine admitted to uremia secondary hyperparathyroidism 78 patients were divided into observation group and control group according to random number table method, 39 cases in each group . Patients in the control group were treated with hemodialysis only. The patients in the observation group were treated with hemodiafiltration and hemoperfusion. The levels of parathyroid hormone, blood urea, serum calcium, serum creatinine, serum phosphorus, hemoglobin and hematocrit . Results The difference of hemoglobin, erythropoietin and hematocrit between the two groups before treatment was statistically significant (both P <0.05). The blood urea and serum creatinine, serum calcium and blood after the last treatment in both groups (P <0.05). There was significant difference in parathyroid hormone between the two groups after the first treatment and before and after the last treatment (P <0.05). Conclusion The combination of hemodiafiltration and hemoperfusion for clinical treatment of patients with secondary hyperparathyroidism of uremia can remove toxins from patients with hyperparathyroidism secondary to uremia more thoroughly and achieve the goal of chronic renal failure Symptoms of effective prevention and treatment.