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目的:比较3种血液血液净化方式治疗尿毒症脑病的治疗效果。方法:收集我院2006年3月～2011年6月维持性透析患者合并尿毒症脑病病例共48例,其中21例行血液透析滤过(HDF)(A组),16例行血液灌流+透析(HD+HF)(B组),11例行血液灌流串联连续性静脉一静脉血液滤过(HP+CVVH)(C组)。比较分析3组治疗缓解率,达到病情缓解的治疗次数,治疗前及治疗结束后,Bun、Scr、K+、Na+、β2-MG、iPTH、HCO3-等指标;结果:经过治疗后,A组治愈17例,缓解1例,缓解率为85.7%,达到治愈或缓解的平均治疗次数:3.78次,B组中治愈12例,缓解2例,缓解率为87.5%,达到治愈或缓解的平均治疗次数:4.15次。C组治愈10例,缓解1例,缓解率为100%,达到治愈或缓解的平均治疗次数:2.36次,A、B2组缓解率及治疗次数均无统计学差异(P>0.05)。C、B2组缓解率及治疗次数均有统计学差异(P<0.05)。结论:3种治疗方法均能有效治疗尿毒症脑病,但C组疗效优于前2组。
Objective: To compare the therapeutic effects of three blood purification methods on uremic encephalopathy. Methods: A total of 48 patients with maintenance hemodialysis patients with uremic encephalopathy were enrolled in our hospital from March 2006 to June 2011. 21 patients underwent hemodiafiltration (HDF) (group A) and 16 underwent hemoperfusion + dialysis (HD + HF) (group B). Eleven patients underwent hemoperfusion with serial continuous venovenous hemofiltration (HP + CVVH) (group C). Comparing the treatment remission rate, the number of treatment to reach the condition of remission, the indexes of Bun, Scr, K +, Na +, β2-MG, iPTH, HCO3- before treatment and after treatment; Results: After treatment, 17 cases, 1 case of remission, remission rate was 85.7%, the average number of treatment to achieve cure or remission: 3.78 times, 12 cases were cured in Group B, 2 cases were relieved, the remission rate was 87.5%, the average number of treatment to cure or remission : 4.15 times. In group C, 10 cases were cured, one case was relieved, and the remission rate was 100%. The average number of treatment to be cured or relieved was 2.36 times. There was no significant difference in remission rate and treatment frequency between groups A and B2 (P> 0.05). The rates of remission and treatment in group C and B2 were significantly different (P <0.05). Conclusion: All the three treatments are effective in treating uremic encephalopathy, but the efficacy in group C is better than the first two groups.