高龄维持性血液透析患者临床特点分析

Analysis of clinical characteristics of elderly patients with maintenance hemodialysis

目的探讨高龄维持性血液透析患者的临床特点。方法对23例高龄维持性血液透析患者(高龄组)透析耐受情况、并发症、透析充分性、营养指标以及其他生化指标进行分析,并以同一透析中心的非高龄老年患者25例作为对照(非高龄组)比较。结果高龄组的血管并发症发生率、感染发生率明显高于非高龄组(P<0.01),心血管并发症主要为低血压,并且透析中经常发生血流不畅。高龄组透析充分性指标尿素氮清除效率(Kt/v)基本达标,但血红蛋白(Hb)、血浆白蛋白(ALB)水平均低于非高龄组(P<0.05),C反应蛋白(CRP)水平高于非高龄组(P<0.05)。结论高龄透析患者透析耐受性差,并发症多,血管通道较差,容易发生营养不良,需要改善营养状况,减少微炎症状态,提高透析耐受性。

Objective To explore the clinical characteristics of elderly patients with maintenance hemodialysis.Methods The dialysis tolerance,complications,dialysis adequacy,nutrition indicators and other biochemical indicators of 23 elderly patients（elderly group） with maintenance hemodialysis were analyzed,and 25 non-elderly patients in the same dialysis center were selected as the control（non-elderly group）.Results The elderly group was significantly higher than the non-elderly group in the incidence of vascular complications and the incidence of infection（P 0.01）.The main vascular complication was hypotension,and poor blood flow occurred constantly during dialysis.In the elderly group,the dialysis adequacy indicator urea nitrogen clearance rate（Kt/v） basically reached the standard,but the hemoglobin（Hb） and serum albumin（ALB） levels were lower than those in the non-elderly group（P 0.05）,and C-reactive protein（CRP） level was higher than that in the non-elderly group（P 0.05）.Conclusion Elderly patients have poor dialysis tolerance,many complications,poor vascular access and easy to suffered from malnutrition,therefore it is necessary to improve the nutrition status,reduce the micro-inflammatory state and improve the dialysis tolerance.