血液透析联合血液灌流治疗尿毒症并发症的疗效观察

目的观察血液透析联合血液灌流对PTH的清除及其对尿毒症并发症的改善情况。方法对常规血液透析中存在皮肤瘙痒、难治性高血压和不宁腿综合征的36例患者进行血液透析联合血液灌流（HD＋HP）治疗,先进行4次HD,然后进行4次HP＋HD治疗,分别在两种方式第1次治疗结束时、第4次治疗后2d抽血化验BUN、Scr、P、Ca、PTH、WBC、PLT,与第1次治疗前比较各成分下降百分率;评估两种方式治疗4次后患者平均动脉压（MAP）、皮肤瘙痒和不宁腿综合征等症状改善情况。结果第1次治疗结束时两种方式BUN、Scr、P、Ca较治疗前下降百分率相近（P〉0.05）,而PTH、WBC、和PLT下降百分率HP＋HD较HD明显（P〈0.01）。第4次HP＋HD治疗后2d PTH下降百分率与第1次治疗前比较下降明显（P〈0.01）,其他各项指标无明显下降（P〉0.05）。HP＋HD治疗4次后患者皮肤瘙痒、难治性高血压和不宁腿综合征症状较治疗前明显改善（P〈0.05）;HD治疗4次后各症状无明显改善（P〉0.05）。结论 HD和HP＋HD都能有效清除小分子物质,而HP＋HD还同时清除中分子物质,对存在的皮肤瘙痒、难治性高血压和不宁腿综合征有较好的疗效。

The efficacy of hemodialysis combined with hemoperfusion in patients with uremia complications

Objective To observe the efficacy of hemodialysis combined with hemoperfusion on clearance of PTH and improvement in patients with uremia complications.Method 36 patients with uremic pruritus and uremic refractory hypertension(RH)and restless leg syndrome(RLS)were treated by hemodialysis plus hemoperfusion(HD+HP).All patients were treated with hemodialysis(HD) four times,and then treated with HD+HP for four times.The descent percentage of serum BUN,Scr,P,Ca,PTH,WBC and PLT were compared after treatment of f...