不同溶媒预冲管路改善血液透析患者皮肤瘙痒的临床观察

目的 观察两种常用的溶媒预冲体外血液循环管路(包括一次性透析器)对改善血液透析患者皮肤瘙痒的临床治疗效果.方法 对22例患者,分为治疗组(11例),采用5%葡萄糖预冲血液透析管路,后进行维持性血液透析;对照组(11例),常规采用0.9%生理盐水预冲血液透析管路,后进行维持性血液透析;每位患者连续观察15次,治疗过程使用的药物包括促红素、透析参数如血流量、透析器及透析机的型号均相同,对两组患者进行瘙痒程度、糖化血红蛋白、血脂、空腹血糖、血补体C3及嗜酸粒细胞计数的比较.结果 5%葡萄糖预冲(治疗组),其透析器显示出较好的相容性,表现在瘙痒程度方面有明显减轻.与0.9%生理盐水预冲(对照组)有显著性差异(P<0.05);但在反应过敏的指标血C3及嗜酸粒细胞计数、糖化血红蛋白、血脂、空腹血糖等方面无显著差异(P>0.05).结论 5%葡萄糖预冲血液透析管路和透析器,能明显减轻血液透析过程中因为使用一次性透析器,导致皮肤瘙痒增高的机率,在短期内对人体血糖和脂代谢影响不明显,相对安全、有效.

The clinical observation for the pruritus of hemodialysis patients with different menstruum recycling

Objective To observe the effect on pruritus with two different menstruum for hemodialyrsis recycling.Methods 22 patients of HD were randomly divided into two groups,"treatment group of 11 cases"and"control group of 11 cases".The treatment group used with model of 5% glucose rinsing.The control group used with model of sodium chloride injection.The hemodialysis patients were observed for 15 times continuously.The dialysis parameters were consistent,including the EPO using,blood flowing volume,the model of dialysis machine and dialyze.Itches degree、glycated hemoglobin、total cholesterol,fasting blood glucose,Complement C3 and Eosinophil Cell Count were also measured.Results Compared with the control group,the treatment group used with model of"5%slucose"could alleviate the pruritus occurrence(P<0.05).There was no significant difference in the aspects of glycated hemoglobin、total cholesterol,fasting blood glucose,Complement C3 and Eosinophil Cell Count(P>0.05).Conclusion The dialysis model used with"5% glucose"recycling could alleviate the pruritus occurrence,and it was no manifest effect on the patients's blood glucose and total cholesterol.It is a relatively safe and effective fashion for dialysis in some aspect.