内科

目的观察血液灌流串联血液透析治疗尿毒症顽固性皮肤瘙痒的疗效。方法将56例尿毒症顽固性皮肤瘙痒患者随机分为两组，观察组接受血液灌流串联血液透析治疗，对照组采用常规血液透析治疗。使用改良Duo氏瘙痒评分法观察两组患者治疗前后2周、4周、8周皮肤瘙痒积分，以及血PTH、β2-MG的变化与不良反应。结果治疗8周后，观察组患者皮肤瘙痒明显好转，Duo积分显著降低，完全缓解率为53.6%（15/28），部分缓解率为28.5%（8/28），总有效率82.1%（23/28）；对照组的完全缓解率为14.3%（4/28），部分缓解率为25.0%（7/28），总有效率39.3%（11/28）。两组比较差异有统计学意义（P＜0.01）。结论血液灌流串联血液透析能有效治疗尿毒症患者顽固性皮肤瘙痒。

ObjectiveTo observe the effect of using hemoperfusion and hemodialysis in series for treating refractory uremic pruritus.Methods56 patients with refractory uremic pruritus were randomly divided into two groups,the observation group(n=28)received hemodialysis and hemoperfusion in series,the control group(n=28)received conventional hemodialysis.Improved Duo′s pruritus score was used to observe skin itching points on 2,4,8 weeks before and after treatment,and also detect serum PTH,β2-MG changes and adverse reactions in the same time points.ResultsAfter 8 weeks,pruritus of patients in the observation group were significantly improved,Duo integral decreased notably,complete remission rate was 53.6% (15/28),partial remission rate was 28.5% (8/28),the total effective rate was 82.1% (23/28);complete remission rate of the control group was 14.3% (4/28),partial remission rate was 25.0%(7/28),the total effective rate was 39.3%(11/28).The difference was statistically significant(P＜0.01).ConclusionHemoperfusion and hemodialysis in series is effective in treating refractory uremic pruritus

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