2010-2013年山西省新进入血液透析患者的流行病学调查分析

发布时间：2018-03-18 05:13

本文选题：血液透析　切入点：发病率　出处：《山西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：[目的] 通过对2010～2013年山西省新进入血液透析患者的发病率、病因、血管通路、常见并发症及死亡原因等方面的基本情况的分析,了解山西省终末期肾病血液透析患者的流行病学资料,为规范临床治疗及持续质量改进提供数据支持。 [方法] 对2010-2013年山西省所有开展血液净化治疗的医疗机构网上直报的8108例新进入血液透析的患者的病例资料进行回顾性分析。各种相关数据的采集通过全国血液净化病例信息登记系统完成。 [结果] (1)山西省新进入血液透析的患者人数逐年递增,2010-2013年血液透析年度发病率分别为每百万人口46.62人、53.44人、62.61人、62.93人；年度发病率男女比例分别为1.22：1、1.28：1、1.29：1、1.41：1,差距逐渐增大；(2)血液透析患者前三位的原发病因依次为慢性肾小球肾炎、糖尿病肾病、高血压肾损害,其中居于首位的是慢性肾小球肾炎,占到全部病因的56.4%,糖尿病肾病及高血压肾损害的比例逐年升高；(3)在新进入透析时的血管通路中,临时中心静脉置管居于第一位,占到53.3%,其次是自体动静脉内瘘占41.2%；(4)新进入血液透析患者的并发症最常见为贫血,其次为高血压、骨矿物质代谢紊乱等；肾性贫血及骨矿物质代谢紊乱的治疗达标率偏低,不足50%；(5)心脑血管事件是血液透析患者死亡的主要原因；(6)终末期肾病患者开始血液透析的年龄最主要集中在40～49岁和50～59岁。 [结论] (1)山西省进入血液透析的患者在逐年增多；(2)血液透析患者前三位原发病因依次为慢性肾小球肾炎、糖尿病肾病、高血压肾损害,其中糖尿病肾病及高血压肾损害的比例逐年升高；(3)进入透析时的血管通路以临时中心静脉插管占的比例最高,其次为自体动静脉内瘘,提示适时透析的问题需得到关注并改进；(4)肾性贫血及骨矿物质代谢紊乱的治疗达标率偏低；(5)心脑血管事件是血液透析患者死亡的主要原因。
[Abstract]:[purpose]. Based on the analysis of the incidence, etiology, vascular access, common complications and causes of death of new hemodialysis patients in Shanxi Province from 2010 to 2013, the epidemiological data of hemodialysis patients with end-stage renal disease in Shanxi Province were analyzed. Provide data support for standardization of clinical treatment and continuous quality improvement. [methods]. The data of 8108 new hemodialysis patients directly reported by all medical institutions in Shanxi Province from 2010 to 2013 were analyzed retrospectively. The collection of various relevant data was carried out through the blood purification disease of the whole country. The information registration system is completed. [results]. (1) the number of new hemodialysis patients in Shanxi Province is increasing year by year. The annual incidence rate of hemodialysis in Shanxi Province from 2010 to 2013 is 46.62 persons per million population, 53.44 patients per million population, 62.61 patients per million population, 62.93 patients per million population. The annual male / female morbidity ratio was 1.22: 1: 1.28: 1.291: 1.41: 1, with the gap gradually increasing.) the first three primary causes of hemodialysis patients were chronic glomerulonephritis, diabetic nephropathy and hypertensive renal damage, among which chronic glomerulonephritis was the leading cause. The proportion of diabetic nephropathy and hypertensive renal damage increased year by year. Accounting for 53.3%, followed by autologous arteriovenous fistula (41.2%) anemia is the most common complication in new hemodialysis patients, followed by hypertension, bone mineral metabolism disorder, etc. The rate of treatment of renal anemia and bone mineral metabolism disorder is low. Cardiovascular and cerebrovascular events are the main cause of death in hemodialysis patients. The age of beginning hemodialysis in patients with end-stage nephropathy is mainly 4049 years old and 50 ~ 59 years old. [conclusion]. (1) the number of patients entering hemodialysis in Shanxi Province is increasing year by year. The first three primary causes of hemodialysis patients are chronic glomerulonephritis, diabetic nephropathy and hypertensive renal damage. Among them, the proportion of diabetic nephropathy and hypertensive renal damage increased year by year. The proportion of temporary central venous catheterization was the highest, followed by autologous arteriovenous fistula. It is suggested that the problem of timely dialysis should be paid attention to and improved. (4) Renal anemia and the treatment of bone mineral metabolism disorder. 5) Cardio-cerebrovascular events are the main causes of death in hemodialysis patients.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.5

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