慢性肾功能衰竭血液透析患者临床特征及预后影响因素调查

发布时间：2018-04-20 18:27

本文选题：血液透析 + 临床特征　；参考：《苏州大学》2016年硕士论文

【摘要】：研究目的本研究旨在通过对苏州部分慢性肾功能衰竭血液透析患者的现况调查,获得患者的基线资料,确定透析患者的透析效果间存在的差异,发现影响透析效果的危险因素。研究方法通过横断面调查研究,采用问卷调查和病历阅读的方法,于2015年12月到2016年4月,对在苏州大学附属一院、苏州大学附属二院和苏州市市立医院血液透析中心进行血液透析治疗的终末期肾病患者进行问卷调查,数据采用spss17.0统计软件进行分析,组间均值采用t检验,率的比较采用?2检验,危险因素与临床并发症及结局的关系则采用单因素和多因素logistic回归分析研究结果本次调查实际有效问卷为306份,其中男性168人,女性138人,平均年龄为56.3±15.64岁,平均透析5.7±4.4年,主要以每周3次的频率进行血透。女性患者的文化程度低于男性,男性患者吸烟、饮酒的比率高于女性。在透析之前合并的慢性病中,高血压最多,患病率为75.82%,其余依次为糖尿病(17.97%)、心血管疾病(9.15%)、脑卒中(5.88%)、肺气肿(3.59%)和肿瘤(2.61%)。其中,男女性患者在糖尿病和肿瘤的患病率显示有统计学差异(p0.05),男性糖尿病患病率高于女性,而男性肿瘤患病率低于女性。患者合并症总发生145例(47.38%),其中感染45例(14.7%),心脑血管合并症21例(6.7%),肾性骨病63例(20.5%),出血16例(5.2%)。在合并感染的45例患者中,以呼吸道感染最常见,为27例(60%),其次为导管感染14例(31.1%)、胃肠道感染4例(8.9%)。单因素和多因素Logistic回归分析结果显示,年龄、透析年份和性别与合并症的发生有关,随着年龄的增加,血透年份的增长,发生合并症的危险性增加(P0.05),与男性患者相比,女性发生合并症的危险性降低。研究结论:本研究调查显示慢性肾功能衰竭血液透析患者的合并症发生率为47.38%,随着年龄的增加,血透年份的增长,发生合并症的危险性增加,与男性患者相比,女性发生合并症的危险性降低。老年人、透析年份长以及男性患者是预防合并症发生的重点人群。
[Abstract]:Objective to investigate the current situation of hemodialysis patients with chronic renal failure (CRF) in Suzhou, obtain baseline data of patients, determine the difference of hemodialysis effect among dialysis patients, and find out the risk factors that affect the hemodialysis effect. Methods from December 2015 to April 2016, a cross-sectional study was carried out in the first affiliated Hospital of Suzhou University, using questionnaires and medical records reading methods. A questionnaire survey was conducted among the patients with end-stage nephropathy treated by hemodialysis in the second affiliated Hospital of Suzhou University and the Center of Hemodialysis in Suzhou City Hospital. The data were analyzed by spss17.0 statistical software, and the mean values between groups were analyzed by t-test. The correlation between risk factors and clinical complications and outcomes was analyzed by univariate and multivariate logistic regression analysis. The actual valid questionnaires were 306, including 168 males and 138 females. The average age was 56.3 卤15.64 years and the average dialysis was 5.7 卤4.4 years. The hemodialysis was performed at the frequency of 3 times a week. The educational level of female patients was lower than that of men, and the rate of smoking and drinking in male patients was higher than that in women. Among the chronic diseases complicated before dialysis, hypertension was the most, the prevalence rate was 75.82, the rest were diabetes mellitus 17.97, cardiovascular disease 9.15, stroke 5.88 and emphysema 3.59) and tumor 2.61. Among them, the prevalence of diabetes and tumor in male and female patients showed statistical difference (p 0.05). The prevalence of diabetes in male was higher than that in female, but the incidence of tumor in male was lower than that in female. There were 145 cases of complications, including 45 cases of infection, 21 cases of cardio-cerebrovascular complications, 63 cases of renal osteopathy, and 16 cases of hemorrhage. Respiratory tract infection was the most common infection, followed by catheter infection in 14 cases and gastrointestinal tract infection in 4 cases. Univariate and multivariate Logistic regression analysis showed that age, year of dialysis and sex were related to the incidence of complications. With the increase of age, the year of hemodialysis, the risk of complications increased (P 0.05), compared with male patients. Women have a lower risk of complications. Conclusion: this study showed that the incidence of complications in hemodialysis patients with chronic renal failure was 47.38. With the increase of age, the year of hemodialysis, the risk of complications increased, compared with male patients. Women have a lower risk of complications. Elderly people, long years of dialysis and male patients are the key population to prevent complications.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R692.5

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