血液灌流、血液透析滤过治疗尿毒症性周围神经病的疗效观察

目的探求治疗尿毒症性周围神经病的有效方法.方法将46例尿毒症性周围神经病行维持性血液透析患者随机分为血液灌流组和血液透析滤过组,血液灌流组在每周2次常规血液透析(HD)的同时,接受每周1次HD 血液灌流(HP)治疗;血液透析滤过组行每周1次常规HD治疗,接受每周2次血液透析滤过(HDF)治疗,治疗前、治疗1个月时分别观察两组患者周围神经病的临床症状、神经反射改善情况及正中神经、胫神经、腓总神经的感觉神经传导速度(SCV)3项指标.结果两组经过1个月的充分透析后,其临床症状、神经反射,正中神经、胫神经、腓总神经SCV均较治疗前有所改善,而血液灌流组SCV的改善程度显著优于血液透析滤过组(P＜0.05).结论尿毒症性周围神经病患者在常规HD治疗的同时接受HP或HDF治疗能有效地改善其周围神经病变.

Effect investigation of hemoperfusion and hemodiafiltration in treating uremic peripheral neuropathy

Objective To investigate an effective treatment of uremic peripheral neuropathy. Methods Forty-six patients with uremic peripheral neuropathy were assigned randomly to hemoperfusion group and hemodiafiltration group. Patients of hemoperfusion group received regular hemodialysis 3 times a week and hemoperfusion once a week. The cases of hemodiafiltration group received regular hemodialysis once a week and hemodiafiltration 2 times a week. The clinical symptoms ,the nerve reflex and the sensory conduction velocity(SCV) of median nerve,tibial nerve and lateral popliteal nerve were observed in each group before and after treatment for 1 months.Result After treatment, the clinical symptoms and nerve reflex showed better than before in each group,but hemoperfusion group was significantly better than hemodiafiltation group (P<0.05).The SCV of median nerve, tibial nerve and lateral popliteal nerve was enhanced faster more in hemoperfusion group than hemodiafiltration group (P<0.05).Conclusion Hemoperfusion and hemodiafiltration are useful for uremic patients with peripheral neuropathy.