高通量血液透析联合血液透析滤过治疗尿毒症血透患者顽固性高血压的临床观察

目的：探讨高通量血液透析联合血液透析滤过治疗尿毒症血透患者顽固性高血压的临床效果观察。方法选取维持性血液透析的尿毒症顽固性高血压(需使用3种以上降压药物降压，血压控制不达标)患者30例，随机分为两组；①串联组(HD+HDF)15例，采用一周2次HD联合1次HDF；②对照组(HD组)15例，单纯进行血液透析，每周3次HD。上述连续治疗3个月。每次HD4h、HDF4h。结果两组患者在经过治疗后均有一定效果，但观察组患者的治疗总有效率93.33%(14/15)明显高于对照组患者的治疗总有效率66.66%(10/15)，观察组患者的并发症发生率6.66%(1/15)明显低于对照组患者的并发症发生率60%(9/15)。观察组患者的满意程度评分(8.52±1.46)分明显高于对照组患者满意程度评分(4.02±0.32)分。所有差异均为显著性差异(P＜0.05)，有统计学意义。结论在临床对于尿毒症血液透析患者实施治疗的过程中，使用高通量血液透析联合血液透析滤过治疗能够取得更加安全有效的治疗效果，患者的满意程度更高，在临床上值得推广应用。

Clinical Observation of High-flux Hemodialysis Combined with Hemodiafiltration Treatment Uremic Hemodialysis Patients with Refractory Hypertension

Objective To observe the clinical effect of high-flux hemodialysis combined with hemodiafiltration therapy in hemodialysis patients with uremia resistant hypertension.Methods 30 patients of hemodialysis uremic refractory hypertension (using three or more antihypertensive drugs lower blood pressure, blood pressure control is not achieved) were randomly divided into two groups. 1. 15 cases of series group (HD + HDF) , use HD twice a week united HDF once a week. 2. 15 cases of control group (HD group), use simple hemodialysis and HD three times a week. Thetreatment was last forthree months with HD4h and HDF4h each time.Results Both groups of patient had been treated effectively to some extent, but the total effective rate (93.33% (14/15) )of patients in observational group was clearly higher than that of the ones in control group (60% (9/15) ). The score (8.52±1.46) of satisfaction degree of patients in observational group was clearly higher than that of the ones in control group (4.02±0.32). All the differences were signiifcant (P<0.05), having a statistical signiifcance.Conclusion The use of high-lfux hemodialysis combined with hemodiafiltration therapy can achieve safer and more effective treatment, higher satisfaction of patients with uremia, which should be widely applied in clinical practice.