不同血液净化方式清除维持性血液透析患者高磷血症的临床对比研究

目的探讨不同血液净化方式对维持性血液透析患者高磷血症的清除效果。方法选取2010年1月至2013年3月枣庄矿业集团枣庄医院维持性血液透析出现高磷血症患者183例,按照随机数字表法将其分为三组,各61例,A、B、C三组患者分别实施血液透析滤过、血流透析+血液灌流、血液透析进行血液净化治疗,治疗2个月后对血磷和甲状腺旁激素变化情况进行分析和比较。结果经过血液净化治疗,三组患者血磷水平与治疗前相比均有明显降低,高磷血症患者均明显减少,且A、B两组患者血磷清除率显著高于C组患者,高磷血症患者显著少于C组,并发症发生率显著低于C组,差异有统计学意义(P<0.05)。A、B两组经过治疗高磷血症患者所占比例、差异均无统计学意义(P>0.05);A、B两组患者并发症发生率分别为26.23%、24.59%,显著低于C组并发症发生率126.23%(χ2=11.275,P=0.028)。结论对维持性血液透析患者实施血液透析滤过、血流透析+血液灌流的血液净化方式有利于控制其血磷水平,减少并发症的发生。

Comparative Clinical Study on Different Ways of Blood Purification in Treating Hyperphosphatemia of Patients under Maintenance Hemodialysis

Objective To explore the curative effect of different ways of blood purification in treating hyperphosphatemia of patients under maintenance hemodialysis. Methods A total of 183 cases of hyperphosphatemia patients under maintenance hernodialysis were randomly divided into three groups, with 61 cases in each group. Patients in group A, B, C were respectively treated with hemodialysis filtration, hemodial- ysis ＋ blood perfusion,hemodialysis for blood purification treatment. The changes of blood phosphorus and thyroid hormone levels were analyzed and compared 2 months after treatment. Resnits After blood purifica- tion treatment,the blood phosphorus levels of patients in three groups were all significantly lower than those before treatment, patients with hyperphosphatemia were significantly reduced, and the blood phosphorus clear- ance rates of patients in group Aand B were significantly higher than those of group C, number of patients with hyperphosphatemia in group A and B was significantly less than group C, the incidence of complications of patients in group A and B was lower than that of group C, the differences mentioned above were all statisti- cally significant（ P 〈 0.05 ）. The blood phosphorus clearance rates of group Aand B, and the proportion of patients with hyperphosphatemia after treatment had no statistically significant difference （ P 〉 0.05 ） ; the complication incidence of group A and B were 26.23% ,24.59%, significantly lower than that of group C （ χ2 = 11. 275, P =0. 028 ）. Conclusion Treatments of hemodialysis filtration, and hemodialysis ＋ blood peffusion for the patients under maintenance hemodialysis is helpful to control the blood phosphorus level, and reduce the incidence of complications.