The Clinical Study Of Hemofiltration Combined Hemoperfusion In Treatment Of Uremic Encephalopathy

Objective:To investigate cause of uremic encephalopathy, clinical features, the use of hemofiltration combined treatment of uremic encephalopathy clinical observation of the effect of blood perfusion.Methods:We selected30patients with maintenance hemodialysis suffering uremic encephalopathy in First Hospital of Zibo City,18males and12females).During hospitalization,after brain CT, MRI, EEG and other tests to confirm the diagnosis, exclude cerebrovascular accident, epilepsy and other central nervous system diseases,and no previous history of traumatic brain injury and central nervous system diseases。 We used Sigma Las scoring criteria lower than7points and in a coma more than six hours. Venous access using semi-permanent fistula or arteriovenous long-term indwelling tube, Randomized as follows:12cases in the control group, using only conventional hemodialysis treatment given;Intervention group18cases, the use of hemofiltration (Continuous venovenous hemoftltration, HDF)+hemoperfusion (Hemoperfusion HP) combination therapy for two times a week.HDF+HP group on the basis of conventional hemodialysis twice weekly plus hemofiltration combined with plasma perfusion treatment。We monitored the changes in blood pressure, blood urea nitrogen, creatinine, parathyroid hormone, β2-microglobulin after4weeks,6weeks,8weeks and three months in the two groups. And changes of the awareness before and after the Las scores of patients were compared. Finally,we analyzed total number of days after the dialysis treatment and mortality in two groups of patients.The result:1. Three months after treatment, blood pressure decreased significantly than before (P<0.05),and blood urea nitrogen (BUN), creatinine (Cr)significantly decreased compared with the previous (P<0.05),sigma Las scores increased significantly in HDF+HP group.2. Blood pressure significantly decreased (P<0.05), also blood urea nitrogen (BUN), creatinine (Cr) significantly decreased compared with the previous (P<0.05).3. Parathyroid hormone (PTH) and β2-microglobul had no significant differences after treatment (P.>0.05).4. In ypotension, hyperkalemia and acute respiratory distress syndrome (Adult respiratory distress syndrome ARDS), the incidence of dangerous events had no difference in2Groups of patients after treatment (P>0.05).5. In18patients of HDF+HP group after treatment,the consciousness of11patients (61.11%) fully recovered, recovery of4patients (22.22%) delayed, three cases transferred to other hospitals for further treatment. The incidence of consciousness recovery in HDF+HP group (61.11%) was significantly higher than HP group (12.98%), with statistical significance (x2=1.594, P=0.042).Conclusion:Hemofiltration combined plasma perfusion in treatment of uremic encephalopathy had significant effect. It can improve the quality of life and reduce complications, worthy of promotion.