HA型血液灌流器与透析器串联治疗尿毒症病人的临床观察

目的 探讨血液灌流器与透析器串联治疗尿毒症病人的临床效果。方法 维持性透析的尿毒症患者30人,随机分为两组,串联组15人,采用透析器与灌流器(HA型)串联进行治疗,每周2次;对照组15人,单纯进行血液透析,每周3次。均采用肝素抗凝,血流量200ml/min。透析液为碳酸氢盐,流速为500ml/min。串联组先血液灌流及透析2小时后再单纯透析2小时,治疗前后检测中分子物质,血尿素氮、肌酐、白蛋白、球蛋白、红细胞数。血色素、白细胞数、血小板数、血压及临床症状。结果 串联组的皮肤瘙痒减轻及中分子物质清除均显著高于对照组(P<0.05,P<0.01),串联组的血色素及白细胞增加均显著高于对照组(P<0.01)。结论 血液透析器与灌流器串联治疗尿毒症病人可有效减轻皮肤瘙痒症及清除中分子物质,弥补了单纯血液透析的缺点。

The clinical study of hemoperfusion cartridge combined with hemodialyzer in series treatment for patients with uremia.

Objective To study the effect of hemoperfusion combined with hemodialysis on the patients with uremia. Methods Thirty maintenance hemodialysis patients with uremia were randomly di vided into two groups: series group and control group. Series group was given the treatment for hemodialysis combined with hemoperfusion twice a week, control group with the treatment of single hemodialysis three times a week. Anticoagulant is heparin.The hemodialysis blood flow rate was 200ml/min, dialysate flow rate was 500ml/min.The series group was treated with hemodialysis and hemoperfusion for two hours, and then with single hemodialysis for two hours again.The middle molecular substance, blood urea nitrogen, creatinine, al-bumin, globulin, hemoglobin, the counts of white blood celis and platelets, blood pressure and clinical mani-festation of the patients were observed before and after the treatment. Results The relief of skin itching and the clearance of middle molecular substance were significantly higher in the series group than the control group (P <0.05, P<0.01) .The hemoglobin and the count of white blood celis were significantly higher in series group than the control group (P<0.01) .Conclusion The treatment of hemodialysis connected with hemoperfusion in series can effcetively clean the middle molecular substance and make up a deficit of hemodialysis.