维持性血液透析患者并发脑出血及其相关因素探讨(附37例报告)

Discussing the pathogenesis of cerebral hemorrhage in maintenance hemodialysis patients:37 case reports

目的探讨维持性血液透析患者并发脑出血的发病机制。方法选择2002—01—2004—12在长海医院接受维持性血液透析患者共261例，根据有无脑出血分成两组：对照组和脑出血组。从两组年龄、血压、血脂、残余肾功能（RRF）、平均透析时间及平均单次透析超滤量等方面作统计学分析。结果脑出血组高血压发生率为81.1％、降压未达标率为83．8％、普通肝素使用率为78．4％、平均RRF为（3.8±1．9），而对照组分别为62．5％、52.7％、52.7％和（7.1±3．3），两者差异有显著性。结论维持性血液透析患者并发脑出血是多因素作用的结果。积极控制血压、选用恰当的抗凝方法以及保护RRF有着重要的临床意义。

Objective To discuss the pathogenesis of cerebral hemorrhage in maintenance hernedialysis patients. Methods From Jan. 2002 to Dec. 2004all the 261 hemodialysis patients in changai Hospital were divided into two groups on the basis of with or without cerebral hemorrhage ： （ 1 ） the control group, （2） the group of cerebral hemorrhage. Clinical data of 261 bemodialysis patients were retrospectively analyzed, Results In the group of cerebral hemorrhage, the incidence of high blood pressure was 81.1% ： the blood pressure after medical therapy not up to standard was 83.8% ; the usage of ordinary heparin was 78,4% ; the average RRF was （3.8 ± 1.9） and those of the control group were 62.5%, 52.7%, 52. 7% and （7. 1 ± 3. 3 ） , There were significant differences between the two groups. Conclusion The maintenance hemodialysis patients with cerebral hemorrhage result from multiple factors, Positive control of the blood pressure, selection of appropriate anticoagulant and protection of RRF have important clinical significance.