發(fā)布時(shí)間：2018-04-05 02:40

  本文選題：Meta分析　切入點(diǎn)：腎透析　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:研究血液透析(HD)聯(lián)合血液灌流(HP)與血液透析濾過(HDF)治療尿毒癥瘙癢的臨床療效。方法:計(jì)算機(jī)檢索Cochrane library、PubMed、CNKI、萬方和維普數(shù)據(jù)庫(kù)中關(guān)于HD聯(lián)合HP與HDF治療尿毒癥患者皮膚瘙癢的隨機(jī)對(duì)照試驗(yàn),手工檢索國(guó)內(nèi)各種醫(yī)學(xué)期刊、專著及會(huì)議資料和學(xué)位論文,檢索時(shí)限為建庫(kù)至2015年10月,同時(shí)查閱所獲取的參考文獻(xiàn)索引。兩名研究者對(duì)檢索收集到的文獻(xiàn)按照制定的納入排除標(biāo)準(zhǔn)進(jìn)行獨(dú)立篩選。采用可視模擬評(píng)分法(VAS)、皮膚瘙癢療效判定標(biāo)準(zhǔn)、Dirk R Kuypers評(píng)分、甲狀旁腺素(PTH)、Ca2+、P3-作為評(píng)價(jià)指標(biāo)。采用Review Manager 5.3軟件進(jìn)行Meta分析。結(jié)果:總共納入隨機(jī)對(duì)照研究9篇,一共有患者405例。Meta分析結(jié)果顯示:HD+HP組比HD+HDF組對(duì)尿毒癥患者皮膚瘙癢治療療效及對(duì)血尿素氮(BUN)的清除效果更好,HD+HDF組比HD+HP組對(duì)維持性血液透析患者的Scr、P3-清除效果更好,而兩組對(duì)PTH的降低及Ca2+的影響差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:HD+HP透析方式對(duì)尿毒癥患者皮膚瘙癢的治療更加有效。
[Abstract]:Objective: to study the clinical effect of hemodialysis (HD) combined with hemoperfusion (HP) and hemodiafiltration (HD) on uraemia pruritus.Methods: a randomized controlled trial of HD combined with HP and HDF for the treatment of skin pruritus in uremic patients was searched by computer in Cochrane library.PubMedi, Wanfang and Wiper databases, and various medical journals, monographs, conference materials and dissertations in China were manually searched.The time limit for the retrieval is to build the database until October 2015, and to consult the index of the reference documents obtained at the same time.Two researchers independently screened the collected literature according to the inclusion exclusion criteria.Visual analogue scoring method was used to evaluate the efficacy of pruritus. The criteria for evaluating the curative effect of pruritus were Dirk R Kuypers score and parathyroid hormone (PTH) and Ca 2 + P3- were used as the evaluation index.Meta analysis was carried out with Review Manager 5.3 software.Results: a total of 9 randomized controlled studies were conducted.The results of Meta-analysis showed that the effect of HDF group was better than that of HD HDF group in the treatment of skin pruritus in uremic patients and the clearance of bun (bun) in blood. HD HDF group was better than HD HP group in the clearance of ScrP3- in maintenance hemodialysis patients.However, there was no significant difference in the decrease of PTH and the effect of Ca2 between the two groups (P 0.05).Conclusion: the treatment of pruritus in uremia patients is more effective.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R692.5

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