38例血液透析治疗10年以上慢性肾衰竭患者的生存质量分析

The Clinical Study of Thirty-eight Chronic Renal Failure Patients with Hemodialysis Treatment for More than Ten Years

目的探讨长期血液透析治疗患者的生存质量。方法对38例血液透析治疗10年以上的慢性肾衰竭患者进行横断面临床研究,项目包括营养状况评估,贫血、钙磷代谢紊乱、继发性甲状旁腺功能亢进、微炎症状态等相关指标的检查,以及患者生活状况的调查。结果在38例患者中,血压控制在正常范围的患者17例,占44.7%;1级高血压的患者18例,占47.4%。营养正常的患者15例,占39.5%;轻中度营养不良的患者21例,占55.3%;重度营养不良的患者仅2例。血红蛋白是(108.8±15.4)g/L,血清总蛋白是(69.0±11.6)g/L,白蛋白是(38.5±7.0)g/L,铁蛋白是(322.4±242.6)ng/ml,转铁蛋白饱和度是(31.3±11.5)%,高敏C反应蛋白水平是(3.6±3.1)mg/L。其中正常的患者23例,占60.5%;钙磷乘积<55mg2/dl2的患者30例,占78.9%;全段甲状旁腺激素<500pg/ml的患者21例,占55.3%。生活能自理的患者35例,占92.1%;坚持体育锻炼的患者13例,占34.2%;与亲属关系和睦的患者36例,占94.7%;对目前生活质量满意和较满意的患者32例,占84.2%。结论慢性肾衰竭的患者通过血液透析治疗,完全能够长期、高质量地存活。

Objective： To explore the quality of life in chronic renal failure patients with long - term hemodialysis treatment. Methods：A clinical transection study was performed in thirty- eight chronic renal failure patients treated with hemodialysis treatment for more than ten years. The nutrition stares of the patients was evaluated by Mortified Quantitative Subjective Assessment. Hemoglobin, caldum puosphate product, intact parathyroid hormone （ iPTH）, high sensitive C reactive protein （HSCRP） were also examined in these patients. Results：Among the thirtyeight patients, seventeen （44.7%） were with normotension, and eighteen （47.4 % ） had grade 1 hypertension. Fifteen （39.5 % ） were in normal nutrition status, twenty one （55.3 % ） had mild to moderate malnutrition. Hemoglobin level was （108.8 ± 15.4）g/L, total protein was （69.0 ± 11.6）g/L, albumin was （38.5± 7.0）g/L, ferritin was （322.4± 242.6）ng/ml, transferring saturation was （ 31.3 ± 11.5） %. The caldum phosphate product was less than 55 mg^2/dl2 in thirty patients （78.9 % ）. iPTH was less than 500 pg/ml in twenty one （55.3 % ）. HSCRP was less than 3 mg/L in twenty three （60.5 % ）. Thirty - five （92.1% ） were selfcare, thirteen （34.2%） with daily exercise, thirty six （94.7%） enjoyed family rapprochenaent, thirty thirty two （84.2%） were satisfied with their life. Condusion： The chronic renal failure patients may maintain a good quality of life through long - term hemodialysis treatment.