糖尿病肾病尿毒症患者的血液透析治疗

Hemodialysis therapy to the Chronic renal failure of Diabetic nephropathy patients.

目的 :观察糖尿病肾病 (DN)尿毒症患者血液透析 (HD)的时机 ,血管通路的建立及透析时的并发症。方法 :糖尿病 (DM)诊断符合WHO诊断标准。DN均依据患者的持续性蛋白尿而诊断。DM病史 13～ 30余年 ,患者平均年龄 5 7 3岁。采用德国产费森尤斯 (fresenius)A2 0 0 8C型人工肾机 ,醋酸盐透析。每周平均透析时数 10～ 12h。2例采用动静脉内瘘。 8例采用动静脉外瘘。结果 :10例患者中最长透析时间为 4年 ,最短为 1年。 4例死亡。死亡原因为心、脑血管并发症。结论 :DN尿毒症患者HD的开始时间要早 ,其血管通路较难建立 ;HD时的并发症较多 ,以低血压更为常见 ,本组发生率为36% ,应当引起注意。

Objective:To study the opportunity of Hemodialysis(HD) in the patient of Diabetic nephropathy(DN),the establishment of vascular road and the complication during HD.Methods:The diagnosis of all Diabetes mellitus(DM) patients confer to the standard by WHO.DN is diagnosed to the consistant proteinuria.The average age is 57 3 years old.The disease history of DM is 13～30 years.The artificial kidney(Fresenius A2008C) is produced by Germany.The methods Ac HD is adopted.HD is performed for 10～12 hours per week.The internal arteriovenous fistula(IAVF) is operated in 2cases.The outer arteriovenous fistula(OAVF) in 8 cases.Results:The longest of HD continues for 4 year,the short for 1 year in 10cases.The death of 4 cases is caused by the complication of the vessel in the heart and brain.Conclusions:The better,the earlier of HD in the patient of Chronic renal failure of DN.The attention should be paid to the complication of HD,especially to the low blood pressure.