不同透析方式下终末期肾病临床多项指标水平的差异性及疗效比较
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Differences and clinical efficacy of multiple clinical indicators in patients with endstage renal disease under different dialysis methods
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    摘要:

    【摘要】目的 比较不同透析方式下终末期肾病(ESRD)患者临床各项指标水平差异性及疗效。方法 选取2016年3月~2017年3月至我院接受透析治疗的ESRD患者84例, 采用随机数字表法将所选病例分为A、B、C 3组, 每组各28例, A组给予普通血透, B组给予床旁血透(CRRT), C组给予腹膜透析, 比较3组治疗前后血钙、血磷、甲状旁腺素、尿素氮(BUN)、血红蛋白(Hb)、炎症因子水平、残余肾功能与心功能指标、不良事件率、生活质量评分。结果 治疗4周后, B组血钙水平显著高于A组与C组(P<005), B组血磷、甲状旁腺素、BUN水平显著低于A组与C组(P<005), 而A组与C组比较无显著差异(P>005);3组血清Hb水平均明显升高(P<005), 组间比较差异无统计学意义(P>005);C组血清超敏C反应蛋白(hsCRP)、白介素(IL6)、肿瘤坏死因子(TNFα)显著低于A组与B组(P<005), 残留肾功能(RRF)明显高于A组与B组(P<005);B与C组LVEF明显高于A组(P<005), B组LVEDV、LVESV明显小于A组与C组(P<005);C组不良事件总发生率明显低于A组与B组(P<005), C组不良事件主要是感染, A组与B组不良事件主要是脑血管疾病与内瘘阻塞。结论 腹膜透析方式下ESRD患者炎症反应较轻, 可保护残余肾功能, 但容易产生感染事件;CRRT血磷、甲状旁腺素及尿素氮清除能力较强, 能提高血钙水平、保护心功能、显著改善患者生活质量;普通血透与CRRT容易产生脑血管并发症或者内瘘阻塞。

    Abstract:

    【Abstract】Objective To compare the differences and curative effect of clinical indicators of patients with endstage renal disease (ESRD) undertaking different dialysis methods.Methods 84 patients with ESRD receiving dialysis from March 2016 to March 2017 in our hospital were included in this study and divided into three groups according to the random number table methods, 28 cases in each group. The patients in group A were given common hemodialysis, the patients in group B given bedside hemodialysis (CRRT), the patients in group C given peritoneal dialysis. The serum calcium, blood phosphorus, parathyroid hormone, urea nitrogen (BUN), hemoglobin (Hb), inflammatory factors, residual renal function, cardiac function, adverse event rate and quality of life scores were compared among the 3 groups before and after treatment.Results After 4 weeks of treatment, the level of serum calcium of the group B was significantly higher than these in the group A and the group C (P<005), while the levels of serum phosphorus, parathyroid hormone and BUN were significantly lower than these in the group A and the group C (P<005). However, there was no significant difference between the A group and the C group (P>005). Serum Hb level significantly increased in the 3 groups (P<005), and there was no significantly difference among the three groups (P>005). The levels of serum hsCRP, IL6 and TNFα in the group C were significantly lower than those in the group A and the group B (P<005). The level of RRF of group C was significantly higher than that in the group A and the group B (P<005).The LVEF level in the group B and the group C was significantly higher than that in the group A (P<005), while the levels of LVEDV and LVESV in the group B were significantly lower than those in the group A and the group C (P<005). The overall incidence rate of adverse events in the group C (1786%) was significantly lower than that in the group A (5714%) and the group B (4643%) (P<005). The adverse events were mainly infection in the group C.Conclusion Under peritoneal dialysis, ESRD patients have mild inflammatory response, but they are prone to infection. CRRT can have strong clearance ability in phosphorus, parathyroid hormone and urea nitrogen and can improve blood calcium levels with the advantage of protecting the heart function and significantly improving the quality of life of patients. Common hemodialysis and CRRT are prone to cerebrovascular complications or internal fistula obstruction.

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  • 在线发布日期: 2018-03-05
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