秦艳东　张伟杰　李敏晖　杨小平　吴小兰

【摘要】 目的：分析多模式組合透析应用于慢性肾衰竭尿毒症患者的效果。方法：选取2019年

2月-2020年2月于本院接受治疗的90例慢性肾衰竭尿毒症患者为研究对象，采用随机数字表法分为A、B、C三组，每组30例。A组给予单纯血液透析治疗，B组给予血液透析及血液滤过治疗，C组在B组的基础上给予血液灌流治疗。比较三组患者的治疗效果和治疗前后肾功能、心功能及并发症发生情况。结果：治疗后，C组的总有效率高于B组，B组的总有效率高于A组（P<0.05）。治疗后，C组的血肌酐、β2-微球蛋白、血尿素氮均低于B组，B组上述指标均低于A组（P<0.05）;C组的尿素清除量与体积比高于B组，B组的尿素清除量与体积比高于A组（P<0.05）。治疗后，C组的射血分数高于B组，B组的射血分数高于A组（P<0.05）;C组的左心室舒张期末内径、左心室舒张末容积、左心室收缩期末内径均小于B组，B组上述指标均小于A组（P<0.05）。治疗后，C组的并发症发生率低于B组，B组的并发症发生率低于A组（P<0.05）。结论：多模式组合透析应用于慢性肾衰竭尿毒症，可提高治疗效果，明显改善患者肾功能及心功能，减少并发症发生。

【关键词】 慢性肾衰竭 血液透析 肾功能 尿毒症 并发症

Analysis of the Effect of Multi-mode Combined Dialysis on Uremia Patients with Chronic Renal Failure/QIN Yandong， ZHANG Weijie， LI Minhui， YANG Xiaoping， WU Xiaolan. //Medical Innovation of China， 2021， 18（23）： -174

[Abstract] Objective： To analyze the effect of multi-mode combined dialysis of patients with uremia of chronic renal failure. Method： A total of 90 patients with uremia of chronic renal failure who were treated in our hospital from February 2019 to February 2020 were selected as the research objects， and they were divided into group A， B， C， according to the random number table method， 30 cases in each group. Group A received simple hemodialysis treatment， group B received hemodialysis and hemofiltration treatment， and group C received hemoperfusion treatment on the basis of group B. The treatment effect， renal function， cardiac function after treatment and complications among the three groups were compared. Result： The total effective rate in group C was higher than that in group B， and that in group B was higher than that in group A （P<0.05）. After treatment， serum creatinine， β2-microglobulin and blood urea nitrogen in group C were lower than those in group B， while those in group B were lower than those in group A （P<0.05）. After treatment， the clearance volume and volume of urea in group C were higher than those in group B， while those in group B were higher than those in group A （P<0.05）. After treatment， ejection fraction of group C was greater than that of group B， group B was greater than that of group A （P<0.05）， left ventricular end-diastolic diameter， left ventricular end-diastolic volume， left ventricular end-systolic diameter of group C were smaller than those of group B， and those in group B were smaller than those of group A （P<0.05）. After treatment， the incidence of complications in group C was lower than that in group B， and that in group B was lower than that of group A （P<0.05）. Conclusion： The application of multi-mode combined dialysis in chronic renal failure uremia， can improve the treatment effect， significantly improve renal function and cardiac function， and reduce the incidence of complications.

[Key words] Chronic renal failure Hemodialysis Renal function Uremia Complications

First-author’s address： Nanhai Hospital， Southern Medical University， Foshan 528244， China

doi：10.3969/j.issn.1674-4985.2021.23.042

我国慢性肾脏病发病率逐年升高[1]，治疗不及时可发展为尿毒症，慢性肾衰竭尿毒症严重影响患者生活质量，甚至危及生命[2]，目前常采取维持性血液透析替代肾脏功能以改善症状，临床应用的血液透析方式主要有血液灌流、血液透析、血液滤过及多模式组合等[3]，不同的透析方法各有优劣，治疗效果也各有差异。……