摘要
目的探讨血液灌流与腹膜透析联合治疗尿毒症脑病(UE)的效果。方法本研究为前瞻性研究,选取2019年1月至2021年12月北部战区总医院肾脏病科收治的100例UE患者,男55例,女45例。年龄(52.84±4.50)岁,年龄范围为25~69岁。采用随机数表法将所有患者随机分为单纯治疗组与联合治疗组,每组50例。单纯治疗组患者接受血液灌流治疗,联合治疗组患者接受血液灌流联合腹膜透析治疗。比较两组患者的阳性与阴性症状量表(PAN-SS)评分、治疗效果、皮肤瘙痒程度,以及血尿素氮、血清肌酐、超敏C反应蛋白(hs-CRP)的水平。结果治疗后7 d,联合治疗组PAN-SS的阴性症状评分[(10.25±2.52)分]、阳性症状评分[(12.36±3.41)分]、一般精神症状评分[(12.36±3.11)分]均低于单纯治疗组[(14.95±3.03)分、(15.69±4.28)分、(20.44±4.15)分],差异有统计学意义(P<0.05)。联合治疗组的有效率[94.0%(47/50)]高于单纯治疗组[72.0%(36/50)],差异有统计学意义(P<0.05)。治疗后7 d、14 d,联合治疗组皮肤瘙痒程度评分[(16.87±3.01)分、(10.81±2.08)分]低于单纯治疗组[(19.12±3.22)分、(13.14±2.15)分],差异有统计学意义(P<0.05)。治疗后7 d,联合治疗组血尿素氮、血清肌酐及hs-CRP水平[(12.33±2.89)mmol/L、(354.63±87.22)μmmol/L、(32.62±4.10)mg/L]低于单纯治疗组[(16.52±3.02)mmol/L、(409.85±95.27)μmmol/L、(45.38±5.17)mg/L],差异有统计学意义(P<0.05)。结论血液灌流与腹膜透析联合治疗可提高UE的治疗效果和毒素清除效果,并可缓解患者的皮肤瘙痒症状。
Objective To explore the clinical effect of hemoperfusion combined with peritoneal dialysis on uremic encephalopathy.Methods In this prospective study,a total of 100 uremic encephalopathy(UE)patients admitted to the department of Nephrology,General Hospital of Northern Theater Command from January 2019 to December 2021 were selected,55 males and 45 females,the average age was(52.84±4.50)years old,ranging from 25 to 69 years old.All patients were divided into simple treatment group and combined treatment group by random number table method,50 patients in each group.Patients in the simple treatment group received hemoperfusion treatment,and patients in the combined treatment group received hemoperfusion combined with peritoneal dialysis treatment.The positive and negative symptom scale(PAN-SS)score,treatment effect,degree of skin pruritus,blood urea nitrogen,serum creatinine,hypersensitive C-reactive protein(hs-CRP)levels were compared between the two groups.Results After 7 days of treatment,the negative symptom score[(10.25±2.52)points],positive symptom score[(12.36±3.41)points]and general psychiatric symptom score[(12.36±3.11)points]of the combined treatment group were lower than those of the simple treatment group[(14.95±3.03)points,(15.69±4.28)points,(20.44±4.15)points],and the differences were statistically significant(P<0.05).The total effective rate of the combined treatment group[94.0%(47/50)]was higher than that of the simple treatment group[72.0%(36/50)],and the difference was statistically significant(P<0.05).On day 7 and 14 after treatment,the skin pruritus score of the combined treatment group[(16.87±3.01)points,(10.81±2.08)points]were lower than that of the simple treatment group[(19.12±3.22)points,(13.14±2.15)points],and the differences were statistically significant(P<0.05).After 7 days of treatment,the levels of blood urea nitrogen,serum creatinine and hs-CRP in the combined treatment group[(12.33±2.89)mmol/L,(354.63±87.22)μmmol/L,(32.62±4.10)mg/L]were lower than those in the simple treatment group[(16.52±3.02)mmol/L,(409.85±95.27)μmmol/L,(45.38±5.17)mg/L],and the differences were statistically significant(P<0.05).Conclusions The combined treatment of hemoperfusion and peritoneal dialysis can improve the therapeutic effect and toxin removal effect of UE,and relieve the skin pruritus symptoms of patients.
作者
刘瑀晗
吴炎
张艳宁
郑红光
Liu Yuhan;Wu Yan;Zhang Yanning;Zheng Hongguang(Department of Nephrology,General Hospital of Northern Theater Command,Shenyang 110016,China;Department of Cadre Diagnosis and Treatment,General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《中国临床实用医学》
2022年第5期55-59,共5页
China Clinical Practical Medicine
基金
辽宁省肾脏疾病转化医学研究中心及协同研究网络建设-基于代谢组学和蛋白组学的肾脏疾病基础与临床转化医学研究基金(2015225010)。
关键词
血液灌流
腹膜透析
尿毒症脑病
血尿素氮
血清肌酐
瘙痒
Hemoperfusion
Peritoneal dialysis
Uremic encephalopathy
Blood urea nitrogen
Serum creatinine
Skin itch
作者简介
通信作者:张艳宁,Email:18604105316@163.com。
