老年尿毒症患者维持性血液透析的疗效观察

Efficacy of Maintenance Hemodialysis in Elderly Patients with Uremia

目的探讨老年尿毒症患者维持性血液透析的临床疗效及预后的对策。方法选取2008年1月～2009年12月期间的67例老年尿毒症血液透析患者（观察组）和同期67例非老年尿毒症血液透析患者（对照组），对比分析观察两组的存活率、死亡原因和各并发症的发生率。结果观察组1年以上的存活率为77．61％．3年以上的存活率为65．67％：而对照组1年以上的存活率为91．04％．3年以上的存活率为82．09％，可见观察组患者的存活率显著低于对照组患者的存活率（P〈0．01）。心血管病是老年患者死亡的最主要原因，其次是感染；透析过程中观察组患者的低血压、感染、心力衰竭和心血管病等并发症与对照组相比差异均有统计学意义。结论提高老年尿毒症血透患者存活率的关键是控制心血管病和感染并发症。

Objective To discuss the clinical efficacy and prog-nosis response of the elderly patients with uremia treated by mainte-nance hemodialysis.Methods Choosing 67 elderly patients with uremia from January 2008 to December 2009,who were treated by maintenance hemodialysis(observation group).And in the same pe-riod,67 non-elderly patients were treated by maintenance hemodial-ysis(control group).To compare and analyse the fraction surviving,cause of death and each incidence of complications.Results The survival rate of observation group was 77.61% for more than one year,and more than 3 years' survival rate was 65.67%;while the survival rate of control group was 91.04% for more than one year,and more than 3 years' survival rate was 82.09%.From all above,we could see the survival rate of observation group was significantly lower than that in the control group(P <0.01).Cardiovascular dis-ease was the main reason of death in elderly patients,followed by infection;low blood pressure,infections,heart failure and complica-tions such as cardiovascular disease in the dialysis patients had sta-tistically significant differences compared with those in the control group.Conclusion The key to improve survival rate in elderly pa-tients with uremia by maintenance hemodialysis is to control cardio-vascular disease and infection complications.