血液透析滤过及血液灌流治疗尿毒症性周围神经病变的临床疗效观察

池艳春; 宋立群; 杨晓梅; 于思明

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中国血液净化 ›› 2006, Vol. 5 ›› Issue (11) : 766-768.

论著

血液透析滤过及血液灌流治疗尿毒症性周围神经病变的临床疗效观察

池艳春1 宋立群2 杨晓梅1 于思明2

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摘要

目的　探讨血液透析滤过(HDF)和血液灌流(HP)对尿毒症性周围神经病变的治疗作用。方法将哈尔滨医科大学四院的45例合并尿毒症性周围神经病变的血液透析患者随机分为血液透析滤过组、血液灌流组和常规血液透析组(HD)。血液透析滤过组在每周两次常规血液透析的同时，接受每周1次血液透析滤过治疗；血液灌流组在每周2次常规血液透析的同时，接受每周1次(HD+HP)治疗；常规血液透析组行每周3次常规HD治疗。治疗前、治疗1个月、2个月时分别观察两组患者周围神经病变的临床症状及正中神经、胫神经、腓总神经的感觉神经传导速度(SCV)。结果　两组经过2个月的充分透析后, 常规血液透析组患者周围神经病变的临床症状及感觉神经传导速度无明显改善。而血液灌流组、血液透析滤过组周围神经病的临床症状和感觉神经传导速度较治疗前有明显改善，其程度显著优于血液透析组(P＜0.05)。结论　尿毒症性周围神经病变患者在常规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。

Abstract

Objective To observe the effect of hemoperfusion and hemodiafiltration in treating uremic perpheral neuropathy. Methods Fourty-five patients with uremic peripheral neuropathy were assigned randomly to hemoperfusion group, hemodiafiltration group and hemodialysis group. Patients of hemodiafiltration group received regular hemodialysis twice a week and hemodiafiltration once a week. The cases of the hemoperfusion group received regular hemodialysis twice a week ahd hemoperfusion once a week. The hemodialysis group received regular hemodialysis thrice 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, 1 month and 2 months cost treatment respectively. Results After treatment, the clinical symptoms,the nerve reflex and the SCV showed no improvement in the hemodialysis group, but significantly improvement in the hemodiafiltration group and hemoperfusion group (P ＜0.05). Conclusion Hemoperfusion and hemodiafiltration are effective for patients with uremic peripheral neuropathy.