不同血液净化方法治疗尿毒症脑病的临床观察

向清; 尹友生; 史伟; 吴金玉; 向彩春

不同血液净化方法治疗尿毒症脑病的临床观察

Clinical observation of different blood purification treatments on uremic encephalopathy

摘要

摘要: 目的:观察连续性血液净化(CBP)、血液透析滤过(HDF)和血液透析(HD)治疗尿毒症脑病的疗效。方法:46例尿毒症脑病(uremic encephalopathy,UE)患者随机分成三组连续性血液净化(CBP)组(n=15)、血液透析(HD)组(n=16)和血液透析滤过(HDF)组(n=15),治疗过程中观察疗效、平均动脉压(MAP)、血清尿素氮(se-rum Bun)、肌酐(Scr)、缓解率及电解质情况。结果:1周缓解率分别为100%(CBP组)、86.7%(HDF组)及62.5%(HD组,P<0.05);CBP治疗后BUN、Scr清除好,电解质、酸碱紊乱得以纠正(P<0.05);治疗前后平均动脉压变化无统计学差异(P>0.05),HDF组发生低血压4次(4/75),HD组发生低血压11次(11/80)。结论:CBP治疗能很好清除BUN、Scr,纠正电解质及酸碱紊乱,对心血管系统干扰小,患者耐受好。

Abstract: Objective:To observe the different effects of CBP,HDF and HD on UE.Methods: 46 patients with UE were divided into CBP group（n=15）,HD group（n=16） and HDFgroup（n=15） randomly.The therapeutic efficacy,remission rate,electrolytes,serum Bun,serum Cr and MAP were observed in the process of treatment.Results: The remission rates within a week were 100%（CBP group）,86.7%（HDF group）and 62.5%（HD group） respectivey（P＜0.05）;CBP could most remove BUN,Scr and correct turbulenice of electrolyte and acid-alkali（P＜0.05）;The change of MAP was insignificationly in CBP,the hypotision occurred 4 times（4/75）in HDF group and 11 times（11/80） in HD group respectively.Conclusion: CBP could most remove BUN,Scr and correct turbulence of electrolyteand acid-alkali,The side effect is very small to cardiovascular system with CBP therapy.The paients can tolerance mostly.

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