不同透析方式治疗终末期肾衰疗效研究

目的:探讨血液透析(HD)、on-line血液透析滤过(on-line HDF)和腹膜透析(PD)三种不同透析方式治疗终末期肾衰效果。方法:选择我院2005~2007年治疗3月以上肾病患者146例,随机分三组,其中HD组44例,on-line HDF组44例,PD组58例,对比分析各组患者的临床资料,疗效和预后。结果:HD组、HDF组和PD组平均年龄分别是49.93、55.38和65.02岁,死亡率分别是27.27、9.09和20.69%。3组对比:PD组发生贫血的程度较轻,重度贫血的发生率低(P1<0.01),高血压的发生率较少,低血压的发生率较高(P2<0.05);蛋白丢失较多(P4,5<0.05)。on-line HDF组与HD组、PD组比较贫血程度、高血压和低血压发生率、血清蛋白变化均无显著差异(P>0.05)。结论:3种治疗方式各有其优缺点,HDF组死亡率低。PD组血压波动小,心血管稳定性好,适合老龄患者,但蛋白丢失量较大,易发生营养不良。

The curative effects of different dialysis therapy for end-stage of renal failure

Objective:In order to choose a better curative way,we evaluate the curative effects of hemodialysis(HD),on-line hemodiafiltration(on-line HDF)and peritoneal dialysis(PD).Methods:146 patients,who have recepted dialysis therapy for more than 3 months in recent 2 years,are divided into 3 groups that are HD group including 44 patients,on-line HDF group including 44 patients and PD group including 58 patients.Estimate their clinical materials,curative effects and outcomes.Results:The patients'average age is 49.93 years old and mortality is 27.27% in HD group.The patients'average age is 55.38 years old and mortality is 9.09% in HDF group.The patients'average age is 65.02 years old and mortality is 20.69% in PD group.Compared 3 groups:In PD group,the degree of anemia is milder and the incidence of serious anemia is low(P1<0.01);the incidence of hypertentian is lower and the incidence of hypotension is higher(P2<0.05);the amout of lost protein is more.The degree of anemia,the incidence of hypertension,the incidence of hypotension and the change of protein in serum in on-line HDF group are similar with HD group and PD group.Conclusions:The advantages and disandvantages are different in 3 groups:the mortality of patients in on-line HDF group is low;in PD group,the scope of fluctuation of blood pressure is small,the stability of cardiovascular is good,so it is fit to old patients,but the amout of lost protein is bigger and the malnutrition is easy to occur.