目的 探求治疗尿毒症性周围神经病的有效方法。方法 将46例尿毒症性周围神经病行维持 性血液透析患者随机分为血液灌流组和血液透析滤过组，血液灌流组在每周2次常规血液透析(HD)的同时，接受每周1次HD+血液灌流(HP)治疗；血液透析滤过组行每周1次常规HD治疗，接受每周2次血液透析滤过(HDF)治疗，治疗前、治疗1个月时分别观察两组患者周围神经病的临床症状、神经反射改善情况及正中神经、胫神经、腓总神经的感觉神经传导速度(SCV)3项指标。结果 两组经过1个月的充分透析后，其临床症状、神经反射，正中神经、胫神经、腓总神经SCV均较治疗前有所改善,而血液灌流组SCV的改善程度显著优于血液透析滤过组( P<0.05)。结论 尿毒症性周围神经病患者在常规 HD治疗的同时接受HP或ＨＤＦ治疗能有效地改善其周围神经病变。

Objective To investigate an effective treatment of uremic peripheral neuropathy. Methods Forty-six patients with uremic peripheral neuropathy were assigned randomly to hemoperfusion group and hemodiafiltration group. Patients of hemoperfusion group received regular hemodialysis 3 times a week and hemoperfusion once a week. The cases of hemodiafiltration group received regular hemodialysis once a week and hemodiafiltration 2 times a week. The clinical symptoms ,the nerve reflex and the sensory conduction velocity(SCV) of median nerve，tibial nerve and lateral popliteal nerve were observed in each group before and after treatment for 1 months. Result After treatment, the clinical symptoms and nerve reflex showed better than before in each group,but hemoperfusion group was significantly better than hemodiafiltation group (P<0.05).The SCV of median nerve, tibial nerve and lateral popliteal nerve was enhanced faster more in hemoperfusion group than hemodiafiltration group (P<0.05). Conclusion Hemoperfusion and hemodiafiltration are useful for uremic patients with peripheral neuropathy.