维持性血液透析不同透析方案患者预后的对比分析

王丽; 刘子栋; 周振安; 刘孝宏; 王璞; 任万军; 李苏

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中国血液净化 ›› 2003, Vol. 2 ›› Issue (4) : 198-200.

论著

维持性血液透析不同透析方案患者预后的对比分析

王丽刘子栋周振安刘孝宏王璞任万军李苏

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摘要

目的研究不同透析方案对患者预后的影响。方法维持透析患者根据其透析方案的不同分为两组， HD组79例，HDF组42例，回顾性分析两组患者1、3、5年死亡率。并对其中65例患者的营养状况、并发症通过调查表、化验检查的方法进行比较。结果 HDF组在透析效率、营养状况、心血管并发症及死亡率方面均优于HD组（ P<0.05）。结论 HD 联合HDF治疗有利于患者的预后。

Abstract

Objective To study the prognosis of different dialysis modalities in maintenance hemodialysis patients. Methods One hundred and twenty-one 121 patients who started renal replacement therapy on HD or HD/HDF between 1997 and 2002 were considered. Seventy-nine patients were treated with HD,the other 42 patients with hemodiafiltration and hemodialysis, mortality were calculated. Sixty-five patients(40 patients with HD,25 with HD/HDF) were studied retrospectively, to eliminate confounding factors,low-molecular efficacy was matched (KT/V 1.50～1.60),and the same membrane material (polysulfone),ultrapure dialysate and the same treatment duration (4.5h)were applied to each group. The serum Alb,PA,BUN were measured,the complications were collected,KT/V,MS were calculated. Results Nutrition status, dosage of blood transfusion and erythropoietin, mortality, cardiovascular morbidity differed in two groups, dialysis-associated hypotensive episodes,hemoglobine did not differ in two groups. Conclusion On-line HDF offers a better cardiocascur stability and clinical improvement.Once a month HDF treatment can also offer a significant benefit when compared with standard hemodialysis.HD combined HDF is a better treatment for maintenance hemodialysis patients.