本文選題：維持性血液透析 + 數(shù)據(jù)庫�。� 參考：《吉林大學(xué)》2017年碩士論文

【摘要】：目的:全面了解中國吉林地區(qū)血液透析患者的流行病學(xué)特點。方法:以2014年-2016年吉林省血液透析病例信息登記系統(tǒng)數(shù)據(jù)(Chinese National Renal Data System,CNRDS)為研究對象,收集病例信息包括:人口學(xué)特征及年度變化、通路、診斷信息(包括原發(fā)病、傳染病等)、實驗室檢驗信息(包括:血紅蛋白、血漿白蛋白、血鈣、血磷、甲狀旁腺激素等相關(guān)檢查)、治療信息(首次血液透析前治療時間、血液透析治療方案、透析充分性評估等)、預(yù)后轉(zhuǎn)歸(包括:轉(zhuǎn)腹膜透析、腎移植、死亡、放棄治療、失訪等)。從而分析吉林省維持性血液透析(Maintenance hemodialysis MHD)患者基本流行病學(xué)特征及透析質(zhì)量情況。結(jié)果:1.截至2016年12月31日吉林省9個地區(qū)共在CNRDS中登記患者數(shù)據(jù)的吉林省透析中心共146家,透析機(jī)2334臺。CNRDS登記的吉林省MHD患者23470例,全省平均每年新增4186例MHD患者,增長率為26.66%。截至2016年12月31日,MHD患者每萬人口點患病率為8.55%。2.2016年維持性血液透析患者平均年齡為(52.63±14.18)歲,男女比例為1.26:1。我省近3年MHD患者前3位原發(fā)病因依次為:原發(fā)性腎小球腎炎、糖尿病腎病、高血壓腎損傷。我省血液透析仍以動靜脈內(nèi)瘺及永久性中心靜脈置管為主,其中72.84%患者使用低分子肝素抗凝。我省近3年MHD患者掉隊率平均為13.57%;轉(zhuǎn)出患者中死亡患者所占比例最高,占31.2%;死亡患者平均年齡為(61.36±11.59)歲;死亡時平均透程為(84.90±67.25)月;各死亡原因中,心血管事件(占47.36%)是發(fā)生死亡的主要原因。3.我省MHD患者血紅蛋白平均水平呈逐年增加趨勢,大于等于110g/L患者比例逐年增加;我省MHD患者2016年和2014年白蛋白達(dá)標(biāo)率明顯高于2015年;在血鈣、磷、PTH方面,達(dá)標(biāo)患者的比例同樣呈逐年上升趨勢;近3年我省MHD患者平均KT/V為1.36,達(dá)標(biāo)率逐年上升。結(jié)論:1.截至2016年12月31日吉林省9個地區(qū)共在CNRDS中登記患者數(shù)據(jù)的吉林省透析中心共146家,透析機(jī)2334臺。血液透析登記患者23470例,每萬人口點患病率為8.55例。2.2016年MHD患者平均年齡為(52.63±14.18)歲,首位原發(fā)病因為原發(fā)性腎小球腎炎。我省血液透析仍以動靜脈內(nèi)瘺及永久性中心靜脈置管為主。心血管事件(47.36%)是發(fā)生死亡的主要原因。乙型病毒性肝炎為我省MHD患者中最常見的傳染病。3.血液透析患者血紅蛋白平均水平逐年增加,≥110g/L患者比例逐年增加;患者2016年和2014年白蛋白達(dá)標(biāo)率明顯高于2015年;血鈣、磷、PTH水平達(dá)標(biāo)患者的比例呈逐年上升趨勢;目前我省主要選擇KT/V作為其評價透析充分性指標(biāo),我省近3年維持性血液透析患者KT/V達(dá)標(biāo)患者所占比例為35.24%、34.59%、34.21%,我省HD質(zhì)量有待進(jìn)一步提高。
[Abstract]:Objective: to investigate the epidemiological characteristics of hemodialysis patients in Jilin area of China. Methods: the data of Chinese National Renal Data system CNRDS from 2014 to 2016 in Jilin Province hemodialysis case registration system were used to collect case information, including demographic characteristics and annual changes, pathway, diagnostic information (including primary disease). Infectious diseases, laboratory testing information (including: hemoglobin, plasma albumin, blood calcium, blood phosphorus, parathyroid hormone, etc.), treatment information (first time before hemodialysis, hemodialysis treatment program, etc.) Dialysis adequacy assessment and prognosis (including peritoneal dialysis, kidney transplantation, death, abandonment of treatment, loss of visit, etc.) The basic epidemiological characteristics and dialysis quality of maintenance hemodialysis (HD) patients in Jilin Province were analyzed. The result is 1: 1. As of December 31, 2016, there are 146 dialysis centers in Jilin Province registered with CNRDS in 9 regions of Jilin Province, 23470 MHD patients registered in Jilin Province with 2334 dialysis machines. The average annual increase in the number of MHD patients in Jilin Province is 4186, with a growth rate of 26.66%. As of December 31, 2016, the prevalence rate of MHD patients per 10,000 population was 8.55 and 2.2016. The average age of maintenance hemodialysis patients was 52.63 鹵14.18 years, and the ratio of male to female was 1.26: 1. The first three primary causes of MHD in recent 3 years were primary glomerulonephritis, diabetic nephropathy and hypertensive renal injury. In our province, arteriovenous fistula and permanent central venous catheterization were the main causes of hemodialysis, and 72.84% of the patients were treated with low molecular weight heparin (LMWH) anticoagulant. In recent three years, the average drop rate of MHD patients in our province was 13.57; the proportion of dead patients was the highest among the patients transferred out, accounting for 31.22.The average age of the dead patients was 61.36 鹵11.59 years; the average dialytic course at the time of death was 84.90 鹵67.25 months; among the causes of death, Cardiovascular events (47.36%) are the leading cause of death. The average hemoglobin level of MHD patients in our province is increasing year by year, and the proportion of patients more than equal to 110g/L is increasing year by year. The albumin reaching standard rate of MHD patients in 2016 and 2014 in our province is obviously higher than that in 2015. The average KT/V of MHD patients in recent three years was 1.36, and the rate of reaching the standard increased year by year. Conclusion 1. As of December 31, 2016, there are 146 dialysis centers and 2334 dialysis machines registered in CNRDS in 9 areas of Jilin Province. The average age of MHD patients in 2016 was 52.63 鹵14.18 years old. The primary cause of primary glomerulonephritis was primary glomerulonephritis. Arteriovenous fistula and permanent central venous catheterization were still the main causes of hemodialysis in our province. Cardiovascular events (47.36) are the leading cause of death. Hepatitis B is the most common infectious disease in patients with MHD in our province. The average level of hemoglobin in hemodialysis patients increased year by year, the proportion of patients with 110g/L 鈮，

本文編號：1908113