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目的:比较连续性血液净化(continuous blood purification,CBP)和血液透析(haemodialysis,HD)治疗尿毒症脑病的疗效。方法:70例尿毒症脑病(uremic encephalopathy,UE)患者随机分成连续性血液净化(CBP)组(n=35)和血液透析(HD)组(n=35),分别给予相应治疗。观察缓解率、平均动脉压、肾功能、电解质及血气指标等。结果:1周缓解率分别为100%(CBP组)和65.7%(HD组)(P<0.05);两组的BUN,Scr,K+,Na+,C1-和β2-MG均显著降低(P<0.05),但治疗后CBP组的BUN,Scr和β2-MG显著低于HD组(P<0.05);CBP组的HCO3-和pH较治疗前显著降低(P<0.05),而HD组中HCO3-和pH治疗前后无显著改变(P>0.05)。CBP组治疗前后平均动脉压变化无统计学差异(P>0.05),HD组低血压发生率为13.7%,高血压发生率为15.4%。结论:CBP治疗能很好清除BUN、Scr和β2-MG,纠正电解质及酸碱紊乱,维持患者血液动力学,具有较好的临床疗效。
Objective: To compare the efficacy of continuous blood purification (CBP) and hemodialysis (HD) in the treatment of uremic encephalopathy. Methods: Seventy patients with uremic encephalopathy (UE) were randomly divided into continuous blood purification (CBP) group (n = 35) and hemodialysis (HD) group (n = 35) Observed remission rate, mean arterial pressure, renal function, electrolytes and blood gas indicators. Results: The rates of 1 week remission were 100% (CBP group) and 65.7% (HD group) respectively (P <0.05). The BUN, Scr, K +, Na +, C1- and β2- 0.05). However, the levels of BUN, Scr and β2-MG in CBP group were significantly lower than those in HD group (P <0.05), and the levels of HCO3- and pH in CBP group were significantly lower than those before treatment - There was no significant difference between before and after treatment (P> 0.05). There was no significant difference in mean arterial pressure before and after treatment in CBP group (P> 0.05). The incidence of hypotension in HD group was 13.7% and the incidence of hypertension was 15.4%. CONCLUSION: CBP can effectively remove BUN, Scr and β2-MG, correct the electrolyte and acid-base disorders, and maintain the hemodynamics of patients with good clinical efficacy.