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血液透析联合结肠透析治疗尿毒症的疗效分析
作者姓名:张海燕  穆亚南
作者单位:湖南省第二人民医院, 湖南 长沙 410007,湖南省第二人民医院, 湖南 长沙 410007
摘    要:目的 观察血液透析联合结肠透析治疗尿毒症的疗效,并分析其起效机制。方法 将2017年2月-2017年8月湖南省第二人民医院收治的60例尿毒症患者,按照随机数字表法分为观察组和对照组,各30例。两组均进行维持性血液透析治疗,观察组联合结肠透析,持续8周。观察治疗前后的相关蛋白水平、钙磷乘积、透析相关并发症等不良事件发生情况、生活质量躯体部分评分。结果 观察组、对照组不良事件发生率分别为26.7%、63.3%,两组比较差异有统计学意义(P<0.01)。与治疗前比较,对照组治疗后Hcy、IS、PCS低于治疗前,差异有统计学意义(P<0.01)。治疗后,观察组Hcy、IS、PCS低于对照组,差异有统计学意义(P<0.01)。治疗后,观察组生活质量躯体部分评分高于治疗前,组间比较观察组高于对照组,差异有统计学意义(P<0.01)。结论 血液透析联合结肠透析可以减轻尿毒症患者躯体症状、降低不良事件发生风险、降低相关蛋白水平,这可能与其提高透析的质量,有效地清除毒素,降低尿毒症引起的组织损害有关。

关 键 词:尿毒症  血液透析  结肠透析  Hcy  IS  PCS
收稿时间:2018/9/10 0:00:00

Efficacy of Hemodialysis Combined with Colon Dialysis in Treatment of Uremia
Authors:ZHANG Haiyan and MU Yanan
Institution:The Second People''s Hospital of Hunan Province, Changsha, Hunan 410007, China and The Second People''s Hospital of Hunan Province, Changsha, Hunan 410007, China
Abstract:Objective To evaluate the efficacy of hemodialysis combined with colon dialysis in the treatment of uremia, and to analyze its mechanism.Methods From February to August, 2017, 60 patients with uremia who were admitted to our hospital were equally divided into observation group and control group using a random number table. Both groups received maintenance hemodialysis for 8 weeks. The observation group received colon dialysis in addition. The levels of related proteins before and after treatment, the incidence of adverse events such as dialysis-related complications, and the score for body part of the Quality of Life (QOL) Scale were evaluated.Results The incidence of adverse reactions was significantly lower in the observation group than in the control group (26.7% vs 63.3%, P<0.01). The levels of homocysteine (Hcy), indoxyl sulfate (IS), and p-cresyl sulfate (PCS) in the control group were significantly reduced after treatment (P<0.01). The levels of Hcy, IS, PCS after treatment were significantly lower in the observation group than in the control group (P<0.01). After treatment, the score for body part of the QOL Scale was significantly improved in the observation group. Moreover, the score for body part of the QOL Scale after treatment was significantly higher in the observation group than in the control group (P<0.01).Conclusion For patients with uremia, hemodialysis combined with colon dialysis can reduce the physical symptoms, risk of adverse events, and levels of related proteins, probably by improving dialysis quality, enhancing toxin clearance, and reducing tissue damages caused by uremia.
Keywords:uremia  hemodialysis  colon dialysis  homocysteine  indoxyl sulfate  p-cresyl sulfate
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