论文部分内容阅读
目的分析维持性血液透析患者并发退缩人综合征的临床特点并对其加强预防、积极治疗。方法选择江门市中心医院血液净化中心规律血液透析合并退缩人综合征患者6例,收集患者一般资料、临床症状、身高变化、生化指标(血清钙、磷、碱性磷酸酶、甲状旁腺素、血红蛋白和血细胞比容)、骨密度和红细胞生成素用量。结果 6例患者透析龄均在7年以上;身高缩短≥10cm;且几乎都伴有贫血症状、生活自理能力下降、骨关节疼痛、骨畸形;6例患者均有高钙血症、骨质疏松、碱性磷酸酶及全段甲状旁腺激素明显升高,经维生素D,冲击治疗无效;其中1例最近行甲状旁腺全切术加上臂移植术。结论退缩人综合征是维持性血液透析患者合并难治性继发性甲状旁腺功能亢进症的一种特殊类型,早期监测并规范治疗继发性甲状旁腺功能亢进,可避免退缩人综合征的发生。
Objective To analyze the clinical features of patients with retentive syndrome in maintenance hemodialysis patients and to improve their prevention and treatment. Methods Six patients with hemodialysis combined with withdrawal syndrome were enrolled in the center of blood purification center of Jiangmen Central Hospital. The general data, clinical symptoms, height, biochemical parameters (serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, Hemoglobin and hematocrit), bone mineral density and erythropoietin dosage. Results The dialysis age of 6 patients was more than 7 years, the height was shortened more than 10cm, and almost all were accompanied by the symptoms of anemia, decreased self-care ability, bone and joint pain and bone deformity. All 6 patients had hypercalcemia, osteoporosis , Alkaline phosphatase and the whole parathyroid hormone was significantly increased by vitamin D, the impact of treatment is invalid; one case of recent total parathyroidectomy plus arm transplantation. Conclusion Retreat syndrome is a special type of refractory secondary hyperparathyroidism in maintenance hemodialysis patients. Early monitoring and standard treatment of secondary hyperparathyroidism can prevent the retreat of human syndrome happened.