摘要
目的探讨腹膜透析联合血液透析治疗终末期肾病的疗效。方法回顾性分析2010年1月至2013年1月在贵州省人民医院及贵州医科大学附属第二医院规律应用腹膜透析、血液透析及二者联合治疗的终末期肾脏病患者128例,排除合并严重心、脑血管疾病及恶性肿瘤,肾移植失功,年龄<18岁及>75岁的透析患者,随访2年。对患者肾脏形态大小、尿量、生化指标,尿素清除指数(KT/V)达标率以及并发症发生率和存活率等进行分析。结果联合组的肾脏形态及长、宽、皮质厚度均大于血液透析组(P<0.05)。腹膜透析组的尿量明显多于血液透析组及联合组(P<0.05),与腹膜透析组相比,联合组血尿素氮(BUN)、血肌酐(Scr)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)明显降低,高密度脂蛋白胆固醇升高(HDL-C),差异有统计学意义(P<0.05);联合组血红蛋白(Hb)和白蛋白(ALB)水平明显高于腹膜透析组和血液透析组,差异有统计学意义(P<0.05)。尿素清除指数(KT/V)联合组达标率明显高于腹膜透析组及血液透析组(P<0.05)。联合组、腹膜透析组、血液透析组总并发症发生率分别为41.2%、47.8%、52.1%。联合组、腹膜透析组、血液透析组患者的生存率分别为87.5%、82.5%、77.5%。结论腹膜透析联合血液透析的疗效尤于单用血液透析或腹膜透析,其并发症少,患者生存率增加,值得临床推广应用。
Objective To explore the effect ofhemodialysis combined with peritoneal dialysis in treating the end-stage renal disease. Methods Retrospectively analyzed 128 patients with end-stage renal disease receiving regular hemodialysis, peritoneal dialysis or both in the People＇s Hospital of Guizhou province or the second affdiated hospital of Guizhou medical university from January 2010 to January 2013. The following conditions were excluded： severe cardio-cerebral vascular disease, malignant tumor, renal allograft failure and age under 18 or older than 75. Follow up for 2 years. The shape and size of kidney, urine volume, biochemical indexes, KT/ V value, the incidence of complications and survival were analysed. Results After different types of dialysis, the renal lengths, widths and cortical thicknesses of patients receiving combination therapy were greater than hemodialysis patients （P〈0.05）. The patients in peritoneal dialysis group had more average urine volume than the others （P〈0.05）. Conclusion with peritoneal dialysis group, the combination group had lower levels of urea nitrogen （BUN）, serum creatinine （Scr）, triglyceride （TG）, low density lipoprotein （LDL-C） and a higher level of high-density lipoprotein （HDL-C）, with statistical significace （P〈0.05）. The levels of hemoglobin （Hb） and albumin （ALB） of the combined group were significantly higher than peritoneal dialysis and hemodialysis group （P〈0.05）. In addition, the KT/V control rate was also significantly higher in combination group than others. The total complication rate was 41.2% in combination group while it was47.8% and 52.1% in peritoneal dialysis group and hemodialysis group repectively; The survival rate was 87.5% in combination group, 82.5% in peritoneal dialysis group, 77.5% in hemodialysis group. Conclusion Combined dialysis treatment for end-stage renal disease has better effect, with fewer complications and increased survival rate, and is worth of clinical promotion.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2016年第9期790-793,共4页
Chinese Journal of Practical Internal Medicine
基金
贵州省科技创新人才团队[黔科合人才团队(2013)4031]
贵州省卫计委基金[gzwkj2014-2-138]
关键词
腹膜透析
血液透析
联合治疗
终末期肾病
残肾功能
peritoneal dialysis
hemodialysis
combination therapy
end-stage renal disease
residual renal function
