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目的对比观察尿毒症难治性高血压患者应用血液透析滤过(HDF)联合规律血液透析(HD)和持续不卧床腹膜透析(CAPD)两种治疗方法的临床疗效。方法将68例尿毒症伴难治性高血压患者随机分为HDF/HD组和CAPD组各34例。HDF/HD组每周采用2次血液透析加上1次血液透析滤过治疗;CAPD组进行持续不卧床腹膜透析,每天腹透液总量8000ml,晚上留腹2000ml,均连续观察治疗3个月。比较2组患者治疗前后血尿素氮(BUN)、肌酐(Cr)及平均动脉压的变化。结果治疗后,2组患者血清BUN及Cr均降低(P<0.05),组间比较差异无统计学意义(P>0.05)。2组患者治疗后平均动脉压均低于治疗前,且CAPD组降低幅度大于HDF/HD组,差异均有统计学意义(P<0.05)。结论尿毒症伴难治性高血压患者采用CAPD治疗,血压控制效果更好,但HDF/HD临床效果也较满意,可针对不同患者选择性应用。
Objective To compare the clinical effects of hemodialysis (HDF) combined with regular hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) in uremic patients with refractory hypertension. Methods 68 cases of uremia with refractory hypertension were randomly divided into HDF / HD group and CAPD group of 34 cases. HDF / HD group twice a week with hemodialysis hemodialysis plus hemodialysis treatment; CAPD group continuous ambulatory peritoneal dialysis, peritoneal dialysis fluid per day total 8000ml, evening abdomen 2000ml, were observed and treated for 3 months . The changes of blood urea nitrogen (BUN), creatinine (Cr) and mean arterial pressure were compared between the two groups before and after treatment. Results After treatment, serum BUN and Cr were decreased in both groups (P <0.05). There was no significant difference between the two groups (P> 0.05). The mean arterial pressure of the two groups after treatment was lower than that before treatment, and the decrease of CAPD group was greater than that of HDF / HD group (P <0.05). Conclusions Patients with uremia and refractory hypertension are treated with CAPD, and blood pressure control is better, but the clinical effect of HDF / HD is satisfactory, which can be selectively applied to different patients.