维持性血液透析患者死亡原因分析及护理干预

Analysis of the death cause and its correlated factors in maintenance hemodialysis patients

目的 对维持性血液透析（MHD）患者死亡原因及相关因素进行探讨,从而采取相应的护理干预.方法 回顾分析我院MHD患者中死亡患者的死亡原因,并与同期透析对照组患者进行相关因素比较.结果 2005年1月至2009年9月在我院血液净化中心行常规血液透析（HD）治疗的120例MHD患者中死亡26例,心血管并发症、脑血管意外和感染是MHD患者死亡的主要原因;选择透析治疗时机过晚、高血压、透析间期体重增加过高、低血红蛋白、低白蛋白等是主要的相关危险因素.结论 重点评估血压、选择早期透析、对患者进行有效的血液透析护理管理,建立个体化的整体透析治疗与护理方案是降低维持性血液透析患者死亡率的关键.

Objective To study the death cause and its correlated factors in maintenance hemodialysis patients in order to adopt the prevention and nursing. Methods To retrospectively analyze the death cause of MHD patient, compare correlated factors with patient who underwent hemodialysis at the same time. Results 26 out of 120 patients underwent HD died from January 2005 to September 2009. Cardiovascular disease, cerebrovascular disease and severe infections were the main death causes in MHD patients; the main correlated risk factor were receiving hemodialysis later, hypertension, fast weight growth, hypohemoglobinemia, hypoalbuminemia. Conclusions It is crucial that assessing blood pressure, receiving hemodialysis earlier, giving effective nursing management, establishing a whole individual set of treatment scheme and nursing plan to reduce the mortality of hemodialysis patients.