發(fā)布時(shí)間：2018-04-26 17:02

  本文選題：維持性血液透析 + 終末期腎臟病�。� 參考：《中國老年學(xué)雜志》2017年13期

【摘要】：目的探討老年維持性血液透析(MHD)患者死亡的相關(guān)因素。方法采用回顧性病例對(duì)照法,分析吉林省2012年1月至2016年1月269例MHD死亡患者一般資料、生化指標(biāo)及透析相關(guān)參數(shù)等,與同期300例MHD生存患者(對(duì)照組)資料相比較。結(jié)果 (1)導(dǎo)致兩組終末期腎臟病(ESRD)病因依次為慢性腎小球腎炎、糖尿病腎病、高血壓腎病、多囊腎、狼瘡性腎炎、慢性間質(zhì)性腎炎、馬兜鈴酸腎病、梗阻性腎病、痛風(fēng)性腎病、腎結(jié)核、其他6例,但MHD死亡組與存活組各項(xiàng)病因無統(tǒng)計(jì)學(xué)差異(P0.05);(2)MHD患者死亡病因依次為心血管事件、腦意外事件、感染、消化道出血、尿毒性腦病、腫瘤、多臟器衰竭、自殺;(3)一般資料比較:死亡組≥60歲患者多于對(duì)照組,而45~59歲者少于對(duì)照組,體質(zhì)量指數(shù)(BMI)低于對(duì)照組,透齡低于對(duì)照組(均P0.05)。(4)生化指標(biāo)及透析充分性比較:死亡組透析前收縮壓(SBP)、透析前舒張壓(DBP)、血磷(P)、鱗磷乘積(Ca×P)均高于對(duì)照組,血紅蛋白(Hb)、血清白蛋白(Alb)、尿素清除指數(shù)(KT/V)均顯著低于對(duì)照組(均P0.05)。結(jié)論 ESRD病因中糖尿病腎病、高血壓腎病比例呈現(xiàn)增長趨勢(shì),而慢性腎小球腎炎比例呈下降趨勢(shì),MHD患者主要死于心腦血管事件、感染、消化道出血,年齡、血壓、透析時(shí)間、營養(yǎng)狀況、低透析充分性等均是威脅MHD患者生命的主要因素。早期充分透析、積極糾正貧血、營養(yǎng)不良、嚴(yán)格控制血壓及防治并發(fā)癥可降低血液透析患者的病死率。
[Abstract]:Objective to investigate the related factors of death in elderly patients with maintenance hemodialysis (MHD). Methods A retrospective case-control method was used to analyze the general data, biochemical indexes and dialysis related parameters of 269 patients with MHD from January 2012 to January 2016 in Jilin Province, and compared with the data of 300 patients with MHD survival (control group) in the same period. Results the causes of ESRD were chronic glomerulonephritis, diabetic nephropathy, hypertension nephropathy, polycystic kidney disease, lupus nephritis, chronic interstitial nephritis, aristolochic acid nephropathy, obstructive nephropathy, gouty nephropathy. Renal tuberculosis, other 6 cases, but there was no significant difference between MHD death group and survival group. The causes of death were cardiovascular event, brain accident, infection, gastrointestinal hemorrhage, urotoxic encephalopathy, tumor, multiple organ failure, in turn, the causes of death were cardiovascular events, brain accident, infection, gastrointestinal hemorrhage, urotoxic encephalopathy, tumor, multiple organ failure. Comparison of general data: patients aged 鈮，

本文編號(hào)：1806876