摘要
目的观察高危尿毒症患者应用每日短时透析的疗效。方法16例常规血液透析(HD)治疗无效或不能耐受HD的高危尿毒症患者改作每周6次、每次2h的血液透析滤过或血液滤过治疗,随访8周。比较每日透析治疗前后患者的透析不良反应、血压、体重变化、每周Kt/V,血清磷、血清白蛋白、血红蛋白、心胸比率、左心重量指数以及SF-36生活质量评价的变化。结果与常规透析比较,患者每周Kt/V从4.36±0.62升高至4.88±0.41(P=0.009),血压下降至趋于正常,透析中低血压反应明显减少,血清白蛋白明显升高,血清磷明显下降,血红蛋白明显升高,心脏缩小(P均<0.05),SF-36生活质量评分明显改善。结论高危尿毒症患者应用每日透析治疗后耐受性良好,并能使血压平稳,透析充分,更好地预防透析骨病,改善患者营养状况,减少及治疗心血管并发症,提高生活质量。
Objective To observe the effect of short daily hemodialysis (DHD) on high risk uremic patients converted from conventional HD . Methods Sixteen high risk patients who were not be able to tolerate or had no response to conventional hemodialysis were converted to 2 hours daily hemofiltration (HF) or hemodiafiltration (HDF) , 6 sessions per week. The hypotension during the course of treatment, and the change of body weight, the weekly Kt/V, the serum phosphorus, the serum albumin, the hemoglobin, the cardiothoracic ratio, (CTR), the left ventricular mass index (LVMI )and SF-36 quality of life scales were compared between pre-DHD and post-DHD, conventional HD and DHD. Results Compared with conventional hemodialysis, in DHD patients, weekly Kt/V increased from 4.36±0.62 to 4.88±0.41 (P=0.009), blood pressure decreased almost to normal, occurrence of hypotension during the session reduced significantly, serum albumin and hemoglobin enhanced significantly, CTR and LVMI were improved. The scores of 6 scales in SF-36, such as physical function (PF ), role physical (RP), bodily pain(BP), general health (GH) ,vitality (VT) , mental health (MH) were significantly improved as well (P< 0.05). Conclusions High risk uremic patients can tolerate the short daily hemodialysis. DHD can keep the blood pressure stable, maintain hemodialysis adequacy,and improve the nutritional status and quality of life.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2005年第5期286-289,共4页
Chinese Journal of Nephrology
基金
浙江省科技厅项目(2003C33052)
