资源描述:
《血液滤过治疗尿毒症皮肤瘙痒临床研究.doc》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、血液滤过治疗尿毒症皮肤瘙痒临床研究(作者:单位:邮编:)作者:王湘川刘春慧杨德辉朱新林【摘要】目的探讨血液滤过治疗尿毒症患者皮肤瘙痒临床疗效及其机制。方法将尿毒症维持血液透析伴有皮肤瘙痒的32例病人,随机分为两组。对照组(16例)继续维持血液透析,治疗组(16例)在血液透析基础上联机应用血液滤过,每周2〜3次,每次4h,疗程1个月,记录皮肤瘙痒消失例数,治疗前后分别查血02微球蛋白(02MGX甲状旁腺激素(PTHb结果治疗后治疗组13例皮肤瘙痒消失;对照组无1例皮肤瘙痒消失;血中02MG,PTH治疗组下降明显,与对照组比较,P0.05o结论
2、血液滤过能改善尿毒症皮肤瘙痒症状,亦可降低血中02MG,PTH浓度。【关键词】血液透析血液滤过皮肤瘙痒尿毒症ClinicalResearchonHemofiltrationforTreatmentofSkinItchinUremiaPatientsAbstract:ObjectiveToinvestigatetheclinicalinfluenceofhemofiltrationonuremiapatients'skinitch.MethodsAnalysiswasconductedontheureimapatientstreatedwit
3、hcontinualhemodialysiscoveringaperiodfromMarch2004toDecember2006inmyhospital,amongwhomthe32patientssufferingfromskinitchwerefurtherdividedintotwogroupsonrandomizationprinciple.Intherapeuticgroup(n=16;9males,7females),thepatients'averageagewas56.8±21.3(mostly20-78)years,and
4、incontrolgroup(n=16;10males,6females)thecounterpartwas57.9±20.8(mostly21-79).Thepatientsinthecontrolgroupweretreatedcontinuallywithhemodialysis,andthoseinthetherapeuticgroupweretreatedadditionallywithhemofiltrationbesideshemodialysis.Thehemofiltrationlastingforonemonthasac
5、oursewasperformed2-3timesaweek(4hourspertime).Beforeandafterthetreatment,theserumP2microglobin(P2MG)andparathyroidhormone(PTH)weremonitoredrespective!y.ResultsAfterthetreatment,thetime,withinwhichtheskinitchsymptomdisappeared,wassignificantlyshorter,andthelevelsof02MGandPT
6、Hinserumweresignificantlylowerinthetherapeuticgroupthaninthecontrolgroup.ConclusionHemofiltrationcannotonlyimprovetheskinitchsymptomofuremiapatients,butdecreasethelevelsof02MGandPTHinserumaswell.Keywords:hemodialysis;hemofiltration;skinitch;uremia皮肤瘙痒是尿毒症最常见的症状之一,约半数患者可出现全
7、身性皮肤瘙痒。血液透析可改善部分病人的症状,而其他病人瘙痒症状仍持续存在。为进一步改善皮肤瘙痒症状,提高尿毒症患者生活质量,我院应用血液滤过治疗皮肤瘙痒,取得满意效果,现报告如下。1资料与方法1.1—般资料2004年3月—2006年12月在我院住院或门诊行维持血液透析病人共78例,其中伴有皮肤瘙痒患者32例,随机分为两组。治疗组16例,男9例,女7例,年龄20〜78岁,平均(56.8±21.3)岁。对照组16例,男10例,女6例,年龄21-79岁,平均(57.9±20.8)岁。所有患者近1个月内无明显心力衰竭、肺水肿及感染。两组患者基线资料
8、经统计学处理无明显差异(P0.05),具有可比性。1.2方法治疗组在血液透析基础上联机应用血液滤过,每周2~3次,疗程1个月;对照组继续维持血液透析。两组病人人工肾机均为金宝AK