新增血液透析患者的流行病学特点和变化趋势

发布时间：2018-01-01 07:17

本文关键词：新增血液透析患者的流行病学特点和变化趋势　出处：《广东医学》2017年S1期 　论文类型：期刊论文

【摘要】：目的了解新增血液透析患者的流行病学特点和变化趋势。方法回顾分析血液净化中心新增血液透析患者的年龄、营养状况、原发疾病、首次透析的时机、血管通路、抗凝疗法、常见并发症、死亡原因等方面的情况。结果 (1)新增血液透析的患者人数逐年递增,平均营养状况水平较正常人低。(2)血液透析患者前3位的原发病因为糖尿病肾病、慢性肾小球肾炎、高血压肾损害。(3)血管通路中,临时中心静脉置管所占的比例最高,占76.7%~81.6%;其次为自体动静脉内瘘。(4)进入血液透析时的肾功能水平逐年改善。(5)选择低分子肝素作为抗凝剂的比例逐年上升,但各年度均未能定期检测患者凝血指标及规范地评估凝血状态。(6)并发症常见为贫血、高血压、骨矿物质代谢紊乱;心脑血管事件是主要的死亡原因。结论应加强患者的就医意识及对肾脏专科医师的继续教育,以期达到患者适时透析治疗,改善预后、降低病死率。
[Abstract]:Objective to understand the epidemiological characteristics and trends of new hemodialysis patients. Methods the age, nutritional status, primary disease and the opportunity of first dialysis were analyzed retrospectively. Vascular access, anticoagulant therapy, common complications, causes of death, etc. Results the number of new hemodialysis patients increased year by year. The mean nutritional status was lower than that of normal subjects. (2) the first three primary diseases of hemodialysis patients were diabetic nephropathy, chronic glomerulonephritis, hypertension and renal damage. The proportion of temporary central venous catheterization was the highest, accounting for 76.7% and 81.6%; Secondly, the renal function of autologous arteriovenous fistula was improved year by year. 5) the proportion of low molecular weight heparin as anticoagulant increased year by year. However, the indexes of coagulation were not detected regularly in each year and the coagulation status was assessed regularly. The complications were anemia, hypertension and disorder of bone mineral metabolism. Conclusion it is necessary to strengthen the patient's consciousness of seeking medical treatment and the continuing education of the renal specialist in order to achieve timely dialysis treatment improve the prognosis and reduce the fatality rate.
【作者单位】：广州医科大学附属第三医院荔湾医院内科;
【分类号】：R459.5
【正文快照】： 慢性肾功能衰竭的发病率越来越高,目前最主要的替代治疗方式是血液透析治疗。随着透析治疗技术和手段不断改进、临床中对透析治疗的认识不断提高,加上我国医保政策的逐步完善,近年接受血液透析的患者逐年增多;但是,血液透析患者的预后仍不理想,死亡率仍保持在较高的水平[1-2]

【相似文献】