甲钴胺联合血液灌流对尿毒症性周围神经病变的临床疗效及护理

目的 观察甲钴胺联合血液灌流对尿毒症性周围神经病变的临床疗效及护理效果。 方法 选取泸州市人民医院2016年3月-2017年3月收治的120例尿毒症性周围神经病变患者,按随机数字表分为2组,对照组在每周2次常规血液透析的基础上,每周进行1次血液灌流治疗。实验组在对照组治疗的基础上,加每周2次甲钴胺注射液皮下注射,0.5 ml/次。治疗8周后分别观察2组患者的治疗效果及周围神经病变的临床症状恢复情况,检测神经反射状况以感觉神经传导速度的变化。治疗期间对患者进行血液灌流过程护理、日常护理和心理护理。 结果 经过8周的治疗,甲钴胺联合血液灌流治疗组患者的总有效率为90.00%,临床表现中肢端疼痛、感觉障碍、麻木感、不宁腿综合征等临床症状显著改善,各有效率分别为89.47%、80.00%、85.71%、87.50%,神经反射消失现象(上肢腱反射消失、膝肢腱反射消失)得到明显缓解,神经(正中神经、腓总神经、胫神经)传导速度较对照组显著加快。患者在血液灌注时未出现凝血、溶血、过敏、渗血、出血、皮肤损伤等状况。 结论 尿毒症患者长期进行血液透析治疗和精心护理,在透析的基础上进行血液灌流能够更加充分的对血液进行净化。甲钴胺的应用能够修复被损伤的神经,同时促进毒素的排出,能缓解患者尿毒症性周围神经病变症状。接受甲钴胺联合血液灌流治疗能有效地改善其周围神经病变,护理效果满意。 

Clinical efficacy and nursing of Mecobalamine Combined with hemoperfusion for uremic peripheral neuropathy

Objective To observe the clinical efficacy and nursing of Mecobalamine Combined with hemoperfusion in uremic peripheral neuropathy. Methods 120 patients with uremic peripheral neuropathy admitted to Luzhou People's Hospital from March, 2016 to March, 2017. Were randomly divided into 2 group,The control group was given 1 hemoperfusion every week on the basis of 2 routine hemodialysis once a week. The experimental group was given subcutaneous injection of mecobalamine twice a week, 0.5 ml/time, On the basis of the treatment of the control group. Check the changes of nerve reflex and sensory nerve conduction velocity. During the treatment period, patients were given hemoperfusion, daily nursing and psychological nursing. Results After 8 weeks of treatment, the total effective rate of the treatment group was 90.00%. The clinical symptoms such as limb pain, sensory disturbance, numbness and restless leg syndrome were significantly improved. The respective effective rates were 89.47%, 80.00%, 85.71% and 87.50% respectively. The disappearance of nerve reflex (upper limb tendon reflex disappearance, knee limb tendon reflex disappearance) was significantly alleviated, and the nerve conduction speed (median nerve, common peroneal nerve, tibial nerve) was significantly faster than that of the control group. No blood coagulation, hemolysis, allergy, bleeding, bleeding, skin damage and other conditions were found during blood perfusion. Conclusion Uremia patients are treated with hemodialysis for a long time. Hemoperfusion on the basis of dialysis can purify the blood more fully. The application of mecobalamine can repair injured nerves and promote the excretion of toxins, which can alleviate the condition of uremic peripheral neuropathy in patients.Mecobalamine Combined with hemoperfusion can effectively improve peripheral neuropathy.