维持性血液透析患者死亡原因及相关危险因素分析

Analysis on the death cause and relative dangerous factors for the patients with maintenance hemodialysis

目的探讨维持性血液透析患者死亡原因和相关危险因素。方法选择2003-01～2007—12在该院肾内科血液净化中心治疗的122例维持性血液透析患者的临床和血液透析资料进行回顾性分析。结果122例患者中，死亡56例，占45．9％，其中因心血管病死亡31例（55．38％），严重感染9例（16．07％），脑血管病7例（12．50％），全身衰竭6例（10．71％），消化道出血3例（5．36％）。其他如贫血、高血压、糖尿病、营养不良、低血压和高钾血症等也是与血液透析死亡密切相关的危险因素。结论心血管病和严重感染是维持性血液透析患者死亡的主要原因。充分透析，积极控制相关的危险因素，防治并发症可降低病死率并提高生存质量。

Objective To probe into the death cause and relative dangerous factors for the patients with maintenance hemodialysis （ MH ）. Methods A retrospective analysis was made on the clinical and hemodialysis material for 122 patients with MH who had ever been treated in the hemopurifieation center of our hospital from January 2003 to December 2007. Results Of 122 patients, 56 patients died, accounting 45.9%, in which 31 cases died of cardiovascular disease （55.38%）, 9 eases died of serious infection （ 16.07% ）, 7 cases died of cerebrovascular disease （ 12.50% ） , 3 cases died of whole-body failure （ 10. 71% ） and 3 cases died of gastrointestinal hemorrhage （5.36%）. The dangerous factors, such as anaemia, hypertension, diabetes mellitus, malnutrition, low blood pressure and hyperkalemia ere, also had close relation with the death in hemodialysis. Condusion The cardiovascular disease and serious infection are the main factors caused the death of patients with MH. The thorough hemodialysis, active control of relative dangerous factors and effective prevention for complications can drop the death rate and improve the quality of life.