血液透析联合血液灌流对老年尿毒症患者的效果分析

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　　[摘要] 目的 分析老年尿毒症患者采取血液透析联合血液灌流的临床疗效。方法 研究目标选择2016年1月—2018年12月期间该院收治的老年尿毒症患者320例，根据计算机随机抽选法将其分为观察组与对照组，对照组单纯采取血液透析治疗，观察组联合采取血液透析、血液灌流治疗，对比两组患者治疗效果，分析患者治疗前后尿素氮等毒素水平指标差异性，统计并比较患者治疗前后生活质量评分。结果 观察组临床治疗效果97.50%优于对照组81.25%（χ2=22.246 0，P<0.05），且治疗后尿素氮（10.04±1.15）mmol/L等毒素水平均低于对照组（t=40.787 4、17.235 0、7.543 0、15.860 6、161.942 1，P<0.05）。观察组老年患者治疗后躯体功能（88.19±2.34）分、生理功能（88.42±2.44）分、精神状态（87.58±3.01）分、健康状态（87.38±3.14）分评分均优于对照组，差异有统计学意义（t=90.808 2、85.863 4、67.371 2、60.362 4，P<0.05）。 结论 对老年尿毒症患者采取血液透析联合血液灌流法治疗效果确切，可大幅度提高生活质量评分，值得推广。
　　[关键词] 血液透析;血液灌流;老年;尿毒症;效果
　　[中图分类号] R692          [文献标识码] A          [文章编号] 1674-0742（2019）09（a）-0008-03
　　[Abstract] Objective To analyze the clinical efficacy of hemodialysis combined with blood perfusion in elderly patients with uremia. Methods The target of this study was 320 patients with uremia who were admitted to our hospital from January 2016 to December 2018. They were divided into observation group and control group according to computer random selection method. The control group was treated with hemodialysis alone. The observation group was treated with hemodialysis and hemoperfusion. The therapeutic effects of the two groups were compared. The differences of toxin levels such as urea nitrogen before and after treatment were analyzed. The quality of life scores before and after treatment were compared and compared. Results The clinical treatment effect of the observation group was 97.50% higher than that of the control group （81.25%）（χ2=22.246 0， P<0.05）， and the levels of toxins such as urea nitrogen （10.04±1.15）mmol/L were lower than the control group after treatment （t=40.787 4， 17.235 0， 7.543 0， 15.860 6， 161.942 1， P<0.05）. The scores of physical function （88.19±2.34）points， physiological function （88.42±2.44）points， mental state （87.58±3.01）points， and healthy state （87.38±3.14）points were better in the elderly patients in the observation group than in the control group （t=90.808 2， 85.863 4， 67.371 2， 60.362 4， P<0.05）. Conclusion The treatment of uremia patients with hemodialysis combined with blood perfusion is effective， which can greatly improve the quality of life score and is worth promoting.
　　[Key words] Hemodialysis; Blood perfusion; Old age; Uremia; Effect
　　慢性肾衰竭是临床较为常见的肾内科疾病，指的是因多种肾脏疾病造成肾功能发生不可逆性退减，直至代谢紊乱、功能丧失的综合征，可简称为慢性肾衰。一旦该疾病发展至末期，即变为尿毒症[1]。其临床症状表现多以蛋白质代谢紊乱、肺水肿、肾出血等为主，对患者身心健康及生活质量均造成严重不良影響。目前，临床普遍以血液透析法治疗尿毒症，其能够帮助患者清除体内多余水分及代谢废物，且可调节体内电解质与酸碱性[2-3]。对于老年尿毒症患者来讲，因其自身体质相对较差，易合并多种病症，常同时服用多类治疗药物，那么单纯采取血液透析无法良好去除体内大分子毒素，影响治疗效果。据相关调查发现，血液灌流可良好去除血液中酚类、呱类药物残留，然而无法去除多余水分，将两种治疗方法联合使用可各自发挥作用，提高治疗质量[4]。该文以2016年1月—2018年12月该院收治老年尿毒症320例患者为实验对象分析血液透析联合血液灌流疗效，现报道如下。
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