老年维持性血液透析患者死亡相关因素分析

发布时间：2018-04-26 17:02

  本文选题：维持性血液透析 + 终末期肾脏病　； 参考：《中国老年学杂志》2017年13期

【摘要】：目的探讨老年维持性血液透析(MHD)患者死亡的相关因素。方法采用回顾性病例对照法,分析吉林省2012年1月至2016年1月269例MHD死亡患者一般资料、生化指标及透析相关参数等,与同期300例MHD生存患者(对照组)资料相比较。结果 (1)导致两组终末期肾脏病(ESRD)病因依次为慢性肾小球肾炎、糖尿病肾病、高血压肾病、多囊肾、狼疮性肾炎、慢性间质性肾炎、马兜铃酸肾病、梗阻性肾病、痛风性肾病、肾结核、其他6例,但MHD死亡组与存活组各项病因无统计学差异(P0.05);(2)MHD患者死亡病因依次为心血管事件、脑意外事件、感染、消化道出血、尿毒性脑病、肿瘤、多脏器衰竭、自杀;(3)一般资料比较:死亡组≥60岁患者多于对照组,而45~59岁者少于对照组,体质量指数(BMI)低于对照组,透龄低于对照组(均P0.05)。(4)生化指标及透析充分性比较:死亡组透析前收缩压(SBP)、透析前舒张压(DBP)、血磷(P)、鳞磷乘积(Ca×P)均高于对照组,血红蛋白(Hb)、血清白蛋白(Alb)、尿素清除指数(KT/V)均显著低于对照组(均P0.05)。结论 ESRD病因中糖尿病肾病、高血压肾病比例呈现增长趋势,而慢性肾小球肾炎比例呈下降趋势,MHD患者主要死于心脑血管事件、感染、消化道出血,年龄、血压、透析时间、营养状况、低透析充分性等均是威胁MHD患者生命的主要因素。早期充分透析、积极纠正贫血、营养不良、严格控制血压及防治并发症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，

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