结肠透析联合保留灌肠治疗慢性肾衰竭的疗效观察

目的观察结肠透析联合保留灌肠治疗慢性肾衰竭的临床疗效。方法将我院109例慢性肾衰竭患者（血肌酐〉133μmol/L未进行血液透析或腹膜透析者）且结肠透析次数〉5次（2~3次/周）观察2周。其中将应用结肠透析联合保留灌肠治疗的69例慢性肾衰竭患者定为治疗组（其中血肌酐值在〉500~1 167μmol/L范围31例,血肌酐值在133~500μmol/L范围38例）。将只应用药用炭胶囊或尿毒清颗粒保留灌肠（1次/d）的40例患者定为对照组,其中应用药用炭胶囊灌肠组20例,应用尿毒清灌肠组20例。均共观察2周。分别观察两组治疗前后的临床症状、血肌酐、尿素氮、血磷、血尿酸来观察结肠透析联合保留灌肠的疗效。结果①所有患者食欲不振、恶心呕吐、乏力症状改善明显。②所有患者经治疗后血肌酐、尿素氮、血磷、血尿酸均较前改善,且结肠透析联合保留灌肠组疗效明显优于只应用尿毒清或药用炭灌肠组（P〈0.05）。③治疗组中所有患者经治疗后血肌酐、尿素氮、血磷、血尿酸均显著下降,差异有统计学意义（P〈0.05）,而血肌酐133~500μmol/L组与血肌酐〉500~1 167μmol/L组相比,对于血肌酐及尿素氮的降低疗效更显著,差异有统计学意义（P〈0.05）,而对于血磷及血尿酸的改变差异无统计学意义（P〉0.05）。结论①与单纯保留灌肠相比,结肠透析联合保留灌肠对于改善慢性肾衰竭患者的临床症状以及对血肌酐、尿素氮、血磷、尿酸的降低均有较明显的效果;②结肠透析联合保留灌肠尤其对于早、中期（血肌酐值在133~500μmol/L范围）慢性肾衰竭患者的疗效更为显著;③结肠透析联合保留灌肠治疗慢性肾衰竭的过程中未出现任何不良反应,且疗效确切。

Effect of colon dialysis combined with retention enema in treatment of chronic renal failure

Objective To observe the effect of colon dialysis combined with retention enema in patients with chronic renal failure（CRF）.Methods 109 cases with CRF in the hospital serum creatinine（SCr） 133 μmol/L and without hemodialysis or peritoneal dialysis） and the number of colon dialysis 5 times（2-3 times/week） were observed for two weeks,among which 69 patients with CRF treated with colon dialysis and retention enema were designated treatment group.In treatment group,SCr 500-1 167 μmol/L had 31 patients,SCr 133-500 μmol/L 38 patients.At the same time,the other forty patients treated with only medicinal carbon capsule or urine poisonous clear particle retention enema（one time/day） were disignated control group（medicinal carbon capsule enema group 20 cases,applied urine poisonous clear enema group of 20 cases）,the other treatments were the same.The clinical symptoms were observed,SCr,urea nitrogen（BUN）,phosphorus（P）,and uric acid（UA） were measured before and after treatment.Results ①The clinical symptoms of 109 patients,poor appetite,nausea and vomiting,languor and debilitation,were all improved.②The serum levels of SCr,BUN,P,UA were decreased significantly in two groups,and treatment group had better effects than control group（P0.05）.③Compared with SCr 500-1 167 μmol/L group,the decreases of SCr and BUN were more significant in SCr 133-500 μmol/L（P0.05）.But the decreases of P and UA were no statistic significance（P0.05）.Conclusion ①Compared with the simple retention enema,colon dialysis combined with retention enema in treatment of CRF to improve the clinical symptoms and reduce SCr,BUN,P,UA were more effective.②Colon dialysis combined with retention enema has obviously curative effects on CRF patients in early and medium stage.③In this process no adverse reaction occurred,the clinical effects are definite.