维持性HD老年患者应用三种不同血液净化方式对皮肤瘙痒的疗效分析 |
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引用本文: | 李新华,周昌娥,杨红荣,吕海燕. 维持性HD老年患者应用三种不同血液净化方式对皮肤瘙痒的疗效分析[J]. 海南医学院学报, 2014, 0(2): 248-250,253 |
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作者姓名: | 李新华 周昌娥 杨红荣 吕海燕 |
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作者单位: | 湖北医药学院附属十堰市太和医院,湖北十堰442000 |
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基金项目: | 湖北省卫生厅资助基金(20123324) |
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摘 要: | 目的:探讨不同血液净化方式对维持性血液透析(HD)老年患者皮肤瘙瘁的疗效。方法:维持性HD且伴有皮肤瘙痒的老年患者63例随机分为(HD)组、血液透析滤过+血液透析(HDF+HD)组和高通量透析(HPD)组,每组各21例,观察临床皮肤瘙痒差异性。结果:3组患者透析前及透析6个月后血尿素氮(BUN)、肌酐(Cr)、钙和尿素清除指数(Kt/V)比较,差异无统计学意义(P〉0.05);而HDFq-HD组和HPD组治疗后患者体内血清甲状旁腺激素(PTH)和B2一微球蛋白(82一MG)水平明显降低,差异具有统计学意义(P〈0.05),患者的视觉模拟评分法(VAS)评分指数也显示患者对皮肤瘙痒的主观感受明显提高,差异具有统计学意义(P〈0.05)。结论:HDF+HD和HPD均减低患者血浆的血磷水平,有效清除PTH和G2一MG大中分子毒物,有效缓解患者的皮肤瘙痒症状。
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关 键 词: | 血液净化 血液透析 高通量透析 血液透析滤过 皮肤瘙痒 |
Three different methods of blood purification on skin pruritus in elderly maintenance hemodi- alysis patients |
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Abstract: | Objective= To explore the effect of different methods of blood purification on itchy skin of the elderly patients with maintenance hemodialysis (HD). Methods= Maintenance HD complicated with pruritus in 63 elderly patients were randomly divided into (HD) group, hemodiafiltration and hemodialysis (HDF-FHD) group and high flux hemodialysis (HPD) group with 21 cases in each group, then difference in skin itching were observed and compared. Results: The level of BUN, Cr, blood calcium and Kt/V val- ue in three groups showed no remarkable change before and after six-month blood dialysis (P0.05). While the level of PTH and 132-MG in HDFq-HD and HPD groups were significantly decreased (P 0.05). The VAS score index indicated that the subjective feelings of itchy skin were greatly improved (P 0.05). Conclusion: HDF+HD and HPD significantly decreased serum phosphorus levels in plasma, effec- tively removed PTH and 132-MG and medium molecular substances, thus to alleviate the patient's skin itch- ing. |
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Keywords: | Blood purification Hemodialysis High flux dialysis Itchy skin |
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