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1.
目的探讨泻浊化瘀汤联合血液透析治疗尿毒症患者的临床效果。方法选取2013年10月-2018年1月收治的107例尿毒症患者,采用随机数字表法分为试验组54例和对照组53例,两组患者均常规采用血液透析治疗,对照组透析治疗的过程中给予基础治疗,观察组给予基础治疗+泻浊化瘀汤,对比两组患者干预前后血液透析后的血肌酐(Scr)、尿素氮(BUN)、血钙、血磷、甲状旁腺激素(PTH)、血清C反应蛋白(CRP)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、Toll样受体4(TLR4)的水平。结果干预前,观察组和对照组的Scr、BUN、血钙、血磷、PTH、TNF-α水平差异无统计学意义(P>0.05);干预后,观察组的血磷、PTH、TNF-α水平均低于对照组(P<0.05),两组的Scr、BUN、血钙差异无统计学意义(P>0.05);干预前,观察组和对照组的血清IL-2、IL-6、TLR4和CRP水平差异无统计学意义(P>0.05);干预后,观察组的血清IL-2、IL-6、TLR4和CRP均低于对照组(P<0.05)。结论泻浊化瘀汤联合血液透析治疗尿毒症患者有利于降低血磷、降低患者的炎症反应程度及TLR4的水平,对于改善血透患者的治疗质量具有一定的作用。 相似文献
2.
本文报告64例曾作过血电解质检查及血气分析的尿毒症患者。旨在推定尿毒症时阴离子隙(AG)的影响因素及临床意义。血Na~+及血Cl~-浓度可影响AG(P<0.01)、AG降低常伴血Cl~-浓度异常(P<0.01),血HCO_3~-浓度和AG值关系不大(P<0.05),酸中毒程度和AG数值之间无对应关系(P>0.05)。认为AG是确定尿毒症酸中毒很有用的参数,但由于受许多因素影响,应用时务须注意。 相似文献
3.
101例尿毒症相关性肺水肿的特殊护理措施 总被引:2,自引:0,他引:2
目的 探讨尿毒症相关性肺水肿的特殊护理措施。方法 对尿毒症相关性肺水肿的护理除常规护理措施外,应做到以下几点特殊护理:①密切观察血压、血氧饱和度、近期尿量变化;②有效控制血压;③采取不同的透析方式适时适量透析超滤、加强透析中的护理;④改善全身营养状况,防止肺部感染;⑤牢记护理程序体位-吸氧-血管扩张药-血液透析;⑥严格控制入量。结果 101例病人中抢救成功84例,死亡13例,自动出院3例。结论 采取治疗和特殊护理对抢救尿毒症相关性肺水肿患者有较好效果。 相似文献
4.
抑郁障碍对血液透析患者的影响 总被引:1,自引:0,他引:1
目的 探讨尿毒症患者产生抑郁障碍的可能因素及其对血液透析的影响,并尝试药物治疗,改善患者的生活质量。方法 选择无精神病史的规律性血透患者51例,进行汉密尔顿抑郁量表(HAMD,24项版本)评分,并分为抑郁组和非抑郁组;在组间进行性别、年龄、文化程度和经济状况的比较,观察患者透析充分性、营养、就业率及顺应性在组间的差异。选择重度抑郁状态者予博乐欣(75-150mg/d)抗抑郁治疗,观察疗效。结果 (1)35.3%的患者存在抑郁障碍;(2)两组的年龄、性别、文化程度和婚姻障碍情况均无显著差异;(3)两组间在医疗付费方式、透前规律性肾科门诊及顺应性、充分性、营养状态方面存在显著差异;(4)在18例中选7例抗抑郁治疗,1个月后HAMD评分均有不同程度下降。结论 抑郁障碍在血透患者中是常见的。它可造成血透患者的顺应性下降、营养不良、透析不充分等。抗抑郁的药物治疗可望改善患者的抑郁状态。 相似文献
5.
Satoshi Hisano Winnie Chan Kay Latta Richard J Krieg Jr. James CM Chan 《Clinical and experimental nephrology》1997,1(3):179-186
Growth retardation is a major complication in children with uremia. Protein restriction, calorie deficit, metabolic acidosis,
renal osteodystrophy, and endocrinologic disturbances contribute to the growth failure. The effect of these factors on growth
retardation can be attenuated in part by therapy with vitamin D metabolites, adequate nutrition, alkalization, and dialysis.
Linear growth in children with uremia is markedly retarded despite normal or increased levels of circulating serum growth
hormone. An increased growth hormone level in children with uremia is due to normal growth hormone secretion from the pituitary
gland and impaired growth hormone clearance in the kidney. However, the elevated growth hormone level does not lead to a commensurate
rise in serum insulin-like growth factor I (IGF-I); the serum IGF-I level is decreased or normal in relation to the degree
of renal failure. This discrepancy suggests growth hormone resistance in the liver in uremia. Recent molecular techniques
open a new era in studying the gene expression for growth hormone or IGF-I. There is no doubt today that growth hormone treatment
has the beneficial effect of growth promotion in children with uremia, which also suggests endogenous growth hormone resistance
in target organs or target cells in uremia. 相似文献
6.
本文应用 ADP、肾上腺素及复合诱聚剂对30例慢性肾功能不全(尿毒症期)病人的血小板聚集功能进行了检测,其中5例在血液透析前后分别测定。结果表明尿毒症患者血小板聚集功能障碍,血液透析有助于改善血小板功能。通过相关性检验,发现尿毒症病人的血小板聚集率与血肌酐值呈负相关性,其意义尚需进一步探讨。 相似文献
7.
Shuu-Jiun Wang Kwong-Kum Liao Hung-Hsiang Liou Shei-Shee Lee Ching-Piao Tsai Kon-Ping Lin Ko-Pei Kao Zin-An Wu 《Muscle & nerve》1994,17(4):411-418
Sympathetic skin response (SSR) and R–R interval variation (RRIV) were studied in 36 chronic, nondiabetic uremics to compare with their nerve conduction studies (NCS) and clinical dysautonomia. Abnormal SSR was noted in 5 (13.9%) patients, abnormal RRIV in 14 (38.9%), and abnormal NCS in 26 (72.2%). The patients were classified into three groups: group (GP) 1: “normal,” n = 21 (58.3%), normal RRIV and SSR; GP 2: “isolated parasympathetic dysfunction,” n = 10 (27.8%), abnormal RRIV and normal SSR; and GP 3: “sympathetic sudomotor dysfunction,” n = 5 (13.9%), abnormal SSR. A significant difference in age was found among the three groups (GP 3 > GP 2 > GP 1; P < 0.0001, ANOVA). After controlling the age factor, we still noted a tendency toward increasing NCS disturbances (distal latency and nerve conduction velocity of peroneal nerve; P < 0.05, multiple regression analysis) and frequencies of clinical autonomic symptoms (postural dizziness and impotence; P < 0.05, Mantel–Hanszel test) from GP 1 to GP 3. Patients with abnormal SSR (GP 3) displayed significantly higher frequencies of postural dizziness and impotence, indicating the relationship between an absence of SSR and clinical dysautonomia. © 1994 John Wiley & Sons, Inc. 相似文献
8.
9.
Ermanno Bonucci Giorgio Gherardi 《Virchows Archiv : an international journal of pathology》1977,373(3):213-231
Summary The ultrastructure of the osteocyte has been studied in 80 needle biopsies from the iliac crest of uremic subjects with renal osteodystrophy.Different types of osteocytes were present in the osseous trabeculae. Those recognizable in completely uncalcified osteoid tissue looked like normal osteocytes, even though the matrix was not mineralized. Those present in hypomineralized areas showed enlarged and irregular lacunae when examined under the light microscope; under the electron microscope these osteolytic-like changes were not evident and were found to have been produced by defective calcification of the perilacunar matrix. Osteocytes placed in matrix whose mineralization was normal were often surrounded by a border of crystals protruding side-to-side from the bone matrix into the lacunar space. Other osteocytes were placed in unusually wide lacunae. They showed evidence of osteolytic activity, chiefly consisting of irregularity of the lacunar wall, presence of flocculent, granular and filamentous material in the pericellular space, and calcification of mitochondria. Degenerating and degenerate osteocytes were also recognizable. 相似文献
10.
J. Phillip Pennell Jacques J. Bourgoignie 《Pflügers Archiv : European journal of physiology》1981,389(2):131-135
The participation of surviving juxtamedullary nephrons in the adaptive changes of glomerular filtration that occur in response to loss of functioning nephron mass was examined by direct micropuncture of the rat renal papilla. The solitary remnant kidney (RK) in rats with an 85% reduction of renal mass demonstrated strikingly elevated values for single nephron glomerular filtration rate (SNGFR) in both superficial (46.1±3.2 nl/min) and juxtamedullary (73.5±6.1 nl/min) nephrons in comparison to respective values observed in normal hydrophenic rats (superficial SNGFR=15.0±1.9nl/min,P<0.001, and juxtamedullary SNGFR=30.2±3.2 nl/min,P<0.001). In RK rats, the proximal portions of both superficial and juxtamedullary nephrons exhibited a marked increase in absolute fluid reabsorption as well as a markedly enhanced delivery of fluid to more distal portions of the nephron. These observations indicate that similar, not preferential, functional adaptations in glomerular filtration occur concommitantly in both superficial and juxtamedullary nephrons consequent to reduction of renal mass. 相似文献