三种血液净化方法治疗尿毒症皮肤瘙痒疗效比较

目的找到一种既有效又经济的血液净化方法治疗维持性血液透析病人的皮肤瘙痒。方法将长期进行维持性血液透析有皮肤瘙痒74例病人随机分为三组:血液透析加血液灌流组(HD+HP)25例,每周3次血液透析,其中每周第一次血液透析串连血液灌流;血液透析加血液滤过组(HD+HDF)24例,每周第一次为血液透析滤过其余两次为血液透析;血液透析加血液滤过间隔血液灌流组(HD+HDF/HP)25例,每周进行两次HD,另外单周加一次HD联合血液灌流治疗,而双周加1次HDF,三组疗程均为16w。治疗前后观察血清甲状膀腺(PTH)的数值变化及患者皮肤瘙痒缓解情况。结果 HD+HP组患者皮肤瘙痒缓解率为88%,HD+HP/HPF组缓解率84%,两者无统计学差异(p>0.05),而HD+HDF组缓解率67%,与前两组比较有明显统计学差异(p<0.05)。结论 HD+HP及HD+HP/HDF但均能有效治疗尿毒症患者皮肤瘙痒,而HD+HP/HDF更经济。

COMPARISON OF THREE METHODS OF BLOOD PURIFICATION ON THEIR CURING EFFECT TREATING PRURITUS INDUCED BY UREMIA

Objective To find an effective and economical method of blood purification to treat pruritus for the long - term hemodialysis patients. Methods We divided the ongoing maintenance hemodialysis patients with skin itching 74 cases into 3 groups randomly： 25 cases were in Hemodialysis ＋ Blood perfusion group （ HD ＋ HP）, the first time for the HD, the other two for the HD ＋ HP in a week; 24 cases were in Blood ＋ blood filtration dialysis group （ HD ＋ HDF）, in a week, the first time for the HDF, the other two for the HD; In Hemodialysis ＋ blood fdtration dialysis interval blood peffusion group （HD ＋ HP/HDF） there were 25 eases, one week the first time for HD ＋ HP, fortnight the first to HDF, then the two for HD. 3 course of treatment all need 16 weeks. We detected the level of parathyroid hormone （PTH） in the blood and observed the situation in patients with pruritus relief after the treatment. Resuits HD ＋ HP group remission rate in patients with symptoms of skin itching was 88% ; HD ＋ HP / HDF group remission rate was 84%, there were no significant difference between the two groups （p 〉 0. 05 ）, while the HD ＋ HDF group remission rate was 67%, compared with the first two groups were statistically significant differences （p 〈 0. 05 ）. Conclusion HD ＋ HP/HDF was an effective and economical method to treat pruritus for the long - term hemodialysis patients.