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目的:对比分析血液透析(HD)、血液透析联合血液透析滤过(HD+HDF)、腹膜透析(PD)三种方式对老年尿毒症患者皮肤瘙痒症的疗效,为老年尿毒症患者皮肤瘙痒症的治疗提供参考。方法:选取2010年3月至2014年3月来我院就诊的老年尿毒症皮肤瘙痒症患者共100例作为研究对象,采用随机数表法随机分为HD组(33例)、联合组(33例)、PD组(34例),在初次透析前后、透析后1个月、透析后2个月记录患者皮肤瘙痒评分,并检测患者全段甲状旁腺激素(i PTH)、β2-微球蛋白(β2-MG)的水平。透析2个月后比较三组对皮肤瘙痒症的疗效。结果:联合组和PD组透析2月后β2-MG水平、i PTH水平、瘙痒症评分明显低于HD组,差异具有统计学意义(P<0.05)。PD组透析2月后β2-MG水平低于联合组,但差异不具有统计学意义(P>0.05)。PD组透析2月后i PTH水平明显低于联合组,差异具有统计学意义(P<0.05)。PD组透析2月后评分明显低于联合组,差异具有统计学意义(P<0.05)。PD组、联合组有效率明显高于HD组,差异具有统计学意义(P<0.05);PD组有效率高于联合组,但差异怒具有统计学意义(P>0.05)。结论 :血液透析联合血液透析滤过与腹膜透析均可以明显降低患者全段甲状旁腺激素、β2-微球蛋白的水平,缓解患者瘙痒症状,提升患者生活质量,值得临床推广。
OBJECTIVE: To compare and analyze the curative effect of hemodialysis (HD), hemodialysis combined with hemodiafiltration (HD + HDF) and peritoneal dialysis (PD) on pruritus in elderly patients with uremia and pruritus in elderly patients with uremia Treatment for reference. Methods: A total of 100 senile patients with uremic pruritus who were admitted to our hospital from March 2010 to March 2014 were selected as study subjects and randomly divided into HD group (n = 33), combination group (n = 33) (N = 34). Pruritus scores were recorded before and after primary dialysis, 1 month after dialysis and 2 months after dialysis. The total parathyroid hormone (i PTH), β 2 -microglobulin Protein (β2-MG) levels. Two months after dialysis compared the efficacy of pruritus in three groups. Results: The levels of β2-MG, i-PTH and pruritus in the combined group and PD group were significantly lower than those in HD group after 2-month dialysis (P <0.05). The level of β2-MG in PD group was lower than that in the combination group after 2-month dialysis, but the difference was not statistically significant (P> 0.05). The level of i PTH in PD group after 2 months of dialysis was significantly lower than that in the combined group (P <0.05). After 2 months of dialysis, the PD group was significantly lower than the combined group, the difference was statistically significant (P <0.05). The effective rate of PD group and combined group was significantly higher than that of HD group, the difference was statistically significant (P <0.05). The effective rate of PD group was higher than that of combined group, but the difference was statistically significant (P> 0.05). Conclusion: Hemodialysis combined with hemodiafiltration and peritoneal dialysis can significantly reduce the level of total parathyroid hormone and β2-microglobulin, relieve the pruritus symptoms and improve the quality of life of patients, worthy of clinical promotion.