不同血液净化方式对尿毒症瘙痒症的影响

发布时间：2018-04-05 02:40

本文选题：Meta分析　切入点：肾透析　出处：《重庆医科大学》2017年硕士论文

【摘要】：目的:研究血液透析(HD)联合血液灌流(HP)与血液透析滤过(HDF)治疗尿毒症瘙痒的临床疗效。方法:计算机检索Cochrane library、PubMed、CNKI、万方和维普数据库中关于HD联合HP与HDF治疗尿毒症患者皮肤瘙痒的随机对照试验,手工检索国内各种医学期刊、专著及会议资料和学位论文,检索时限为建库至2015年10月,同时查阅所获取的参考文献索引。两名研究者对检索收集到的文献按照制定的纳入排除标准进行独立筛选。采用可视模拟评分法(VAS)、皮肤瘙痒疗效判定标准、Dirk R Kuypers评分、甲状旁腺素(PTH)、Ca2+、P3-作为评价指标。采用Review Manager 5.3软件进行Meta分析。结果:总共纳入随机对照研究9篇,一共有患者405例。Meta分析结果显示:HD+HP组比HD+HDF组对尿毒症患者皮肤瘙痒治疗疗效及对血尿素氮(BUN)的清除效果更好,HD+HDF组比HD+HP组对维持性血液透析患者的Scr、P3-清除效果更好,而两组对PTH的降低及Ca2+的影响差异无统计学意义(P0.05)。结论:HD+HP透析方式对尿毒症患者皮肤瘙痒的治疗更加有效。
[Abstract]:Objective: to study the clinical effect of hemodialysis (HD) combined with hemoperfusion (HP) and hemodiafiltration (HD) on uraemia pruritus.Methods: a randomized controlled trial of HD combined with HP and HDF for the treatment of skin pruritus in uremic patients was searched by computer in Cochrane library.PubMedi, Wanfang and Wiper databases, and various medical journals, monographs, conference materials and dissertations in China were manually searched.The time limit for the retrieval is to build the database until October 2015, and to consult the index of the reference documents obtained at the same time.Two researchers independently screened the collected literature according to the inclusion exclusion criteria.Visual analogue scoring method was used to evaluate the efficacy of pruritus. The criteria for evaluating the curative effect of pruritus were Dirk R Kuypers score and parathyroid hormone (PTH) and Ca 2 + P3- were used as the evaluation index.Meta analysis was carried out with Review Manager 5.3 software.Results: a total of 9 randomized controlled studies were conducted.The results of Meta-analysis showed that the effect of HDF group was better than that of HD HDF group in the treatment of skin pruritus in uremic patients and the clearance of bun (bun) in blood. HD HDF group was better than HD HP group in the clearance of ScrP3- in maintenance hemodialysis patients.However, there was no significant difference in the decrease of PTH and the effect of Ca2 between the two groups (P 0.05).Conclusion: the treatment of pruritus in uremia patients is more effective.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692.5

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