高通量血液透析联合血液透析滤过序贯治疗慢性肾衰竭临床观察

发布时间：2018-02-02 12:04

本文关键词： 慢性肾衰竭高通量血液透析血液透析滤过　出处：《山东医药》2017年37期 　论文类型：期刊论文

【摘要】：目的观察高通量血液透析(HFHD)联合血液透析滤过(HDF)序贯治疗慢性肾衰竭的效果。方法采用随机数字表法将35例维持性血液透析患者分为对照组17例、观察组18例。对照组每周3次HFHD,观察组每周2次HFHD、1次HDF,每次透析时间均为4 h。分别于透析前及透析6、12个月检测两组血压、BMI、重组促红素用量、血红蛋白、尿素氮、肌酐、血磷、血清白蛋白、血清铁蛋白、透析前血清全段甲状旁腺激素,计算转铁蛋白饱和度、尿素清除率、单室尿素清除指数及β2微球蛋白(β2-MG)清除率;记录两组透析期间发生的不良反应及并发症。结果透析后6、12个月两组血清白蛋白、收缩压及β2-MG清除率比较差异有统计学意义(P均0.05),其他指标比较差异无统计学意义(P均0.05)。透析过程中观察组不良反应发生率低于对照组(P0.05)。结论与单纯HFHD比较,HFHD联合HDF序贯治疗慢性肾衰竭可使患者丢失更多营养成分,但可较好地清除β2-MG及控制收缩压。
[Abstract]:Objective to observe the high flux hemodialysis (HFHD) combined with hemodiafiltration (HDF). Methods 35 patients with maintenance hemodialysis were randomly divided into control group (n = 17) and control group (n = 17). There were 18 cases in the observation group. The control group had HFHD 3 times a week, the observation group had HFHDF twice a week, the time of each dialysis was 4 hours. The blood pressure of the two groups was measured at 12 months. The dosage of recombinant propofol, hemoglobin, urea nitrogen, creatinine, serum phosphorus, serum albumin, serum ferritin, and serum parathyroid hormone before dialysis were measured. Transferrin saturation, urea clearance rate, single chamber urea clearance index and 尾 2 microglobulin (尾 2 MG) clearance were calculated. Results there were significant differences in serum albumin, systolic blood pressure and clearance rate of 尾 2-MG between the two groups at 6 and 12 months after dialysis (P < 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (P 0.05). Conclusion compared with simple HFHD, the incidence of adverse reactions in the observation group was lower than that in the control group. HFHD combined with HDF in sequential treatment of chronic renal failure can lead to the loss of more nutrients, but it can better eliminate 尾 2-MG and control systolic blood pressure.
【作者单位】：江苏大学附属医院;
【分类号】：R692.5
【正文快照】： 慢性肾衰竭患者采用常规血液透析治疗对中分子毒素的清除不足,易引起并发症,病死率高[1]。为提高透析质量,目前对维持性血液透析患者多采用高通量透析器进行高通量血液透析(HFHD)。高通量透析器是其超滤系数20 m L/(h·mm Hg),其透析膜对水及溶质有更好的通透性,其较大的膜孔

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