血液透析聯(lián)合血液灌流對(duì)腎性骨病的治療作用研究

黃佳麗　鄧麗貞　黃宇靜

【摘要】 目的：研究與分析血液透析聯(lián)合血液灌流對(duì)腎性骨病的治療作用。方法：選取本院2016年1月-2017年6月收治的腎性骨病患者50例為研究對(duì)象，按照隨機(jī)分?jǐn)?shù)字表法將其為對(duì)照組和觀察組，各25例。對(duì)照組采取血液透析治療，觀察組在對(duì)照組的基礎(chǔ)上聯(lián)合血液灌流治療。觀察對(duì)比兩組治療前后血清甲狀旁腺激素（iPTH）、血鈣、血磷等水平變化以及治療效果。結(jié)果：治療前，兩組iPTH、血鈣、血磷比較，差異均無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）；治療后，觀察組iPTH、血磷水平均低于對(duì)照組，血鈣水平高于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組治療總有效率為92.0%，高于對(duì)照組的72.0%，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：血液透析聯(lián)合血液灌流對(duì)腎性骨病的治療作用非常顯著，既能顯著改善患者的臨床癥狀，又能改善其血清甲狀旁腺激素、血鈣、血磷等水平，從而達(dá)到較好療效，值得推廣應(yīng)用。

【關(guān)鍵詞】 腎性骨病； 血液透析； 血液灌流

Study on the Therapeutic Effect of Hemodialysis Combined with Hemoperfusion on Renal Osteopathy/HUANG Jiali，DENG Lizhen，HUNAG Yujing.//Medical Innovation of China，2018，15（07）：108-110

【Abstract】 Objective： To study and analyze the hemodialysis combined with hemoperfusion in treatment of renal osteodystrophy.Method：50 patients with renal osteodystrophy in our hospital from January 2016 to June 2017 were selected as the research objects，according to the random digital table method，the patients were divided into control group and observation group，25 cases in each group.The control group was given the blood dialysis treatment，on the basis of this，the observation group combined with hemoperfusion.The changes of serum parathyroid hormone（iPTH），serum calcium and serum phosphorus before and after treatment and effect of the two groups were observed and compared.Result：Before treatment，there were no significant differences in iPTH，calcium and phosphorus between the two groups（P>0.05）.After treatment，the levels of iPTH，serum phosphorus of the observation group were lower than those in the control group，the level of serum calcium in the observation group was significantly higher than that in the control group（P<0.05）.The total effective rate of treatment in the observation group was 92.0%，which was higher than 72.0% in the control group，the difference was statistically significant（P<0.05）.Conclusion：The effect of hemodialysis combined with hemoperfusion on the treatment of renal osteopathy is very significant，it can improve the clinical symptoms of the patients and the levels of serum parathyroid hormone，serum calcium， serum phosphorus and so on，so as to achieve a better curative effect，it is worthy of popularizing and applying.

【Key words】 Renal osteopathy； Hemodialysis； Hemoperfusion

First-authors address：The First Peoples Hospital of Zhaoqing，Zhaoqing 526020，China

doi：10.3969/j.issn.1674-4985.2018.07.030

在臨床上，腎性骨病又稱腎性骨營(yíng)養(yǎng)不良，是一種骨代謝紊亂疾病，屬于慢性腎臟病的常見(jiàn)并發(fā)癥。該病癥主要臨床癥狀為甲狀旁腺代謝紊亂、血磷高、血鈣低等。目前腎性骨病的發(fā)病機(jī)制尚未明確[1-3]。而腎病患者采取血液透析治療的過(guò)程中，只能將小分子物質(zhì)清除，不能將蛋白結(jié)合毒素以及中、大分子毒素等有效清除[4-6]。因此本文就血液透析聯(lián)合血液灌流對(duì)腎性骨病的治療作用進(jìn)行了研究與分析，現(xiàn)將研究結(jié)果報(bào)道如下。

1 資料與方法

1.1 一般資料 選取本院2016年1月-2017年6月收治的腎性骨病患者50例為研究對(duì)象。按照隨機(jī)數(shù)字表法將其分為對(duì)照組和觀察組，各25例。該研究已經(jīng)倫理學(xué)委員會(huì)批準(zhǔn)，患者均知情同意。

1.2 方法 入院后，兩組均加強(qiáng)飲食指導(dǎo)、病情監(jiān)測(cè)以及運(yùn)動(dòng)指導(dǎo)等。在此基礎(chǔ)上，對(duì)照組采取血液透析治療，血液透析機(jī)為瑞典金寶AK-200UtraS型，透析器為德朗空心纖維血液透析器。即……