维持性血液透析慢性肾功能衰竭患者死亡原因调查及相关因素分析

Study on the cause of death and the related factors of chronic renal failure patients by maintenance hemodialysis

目的探讨维持性血液透析慢性肾功能衰竭患者死亡原因和影响因素。方法采用自编问卷收集仙桃市第一人民医院肾内科2010年12月~2012年12月收治的400例维持性血液透析慢性肾功能衰竭患者的临床资料,根据患者的死亡与否将符合纳入条件和排除条件的患者分为对照组和观察组,采用描述性统计和二分类Logistic回归分析维持性血液透析慢性肾功能衰竭患者死亡原因和影响因素,并采取针对性的预防干预措施降低患者的死亡率提供参考依据。结果维持性血液透析慢性肾功能衰竭患者死亡率为7.25%,死亡原因以心脏疾病和脑血管疾病为主,多因素Logistic回归分析发现：高容量负荷和左心室肥厚是维持性血液透析慢性肾功能衰竭患者死亡的危险因素,而尿素清除指数（Kt/V）≥1.2是维持性血液透析慢性肾功能衰竭患者死亡的保护因素。结论维持性血液透析慢性肾功能衰竭患者死亡原因心脏疾病和脑血管疾病为主,死亡受多方面因素影响,我们应该采取针对性的措施来降低患者的死亡率,改善患者的预后。

Objective To investigate the cause of death and the related factors of chronic renal failure patients by maintenance hemodialysis. Methods The clinical data of four hundred chronic renal failure patients who were treated in the nephrology department of our hospital from December 2010 to December 2012 were collected by the self-made general data questionnaire, they were divided into the control group and the observation group according to chronic renal failure patients with or without death, and then they were analyzed by descriptive statistics and binary classification logistic regression analysis of the SPSS 16.0 to find out the influential factors of chronic renal failure patients by maintenance hemodialysis and put forward preventive intervention measures. Results The mortality rate was 7.25%,the death cause of chronic renal failure patients were priority to heart disease and cerebrovascular diseases, multiple logistic regression analysis showed that high capacity load and left ventricular hypertrophy had risk factors of chronic renal failure patients by maintenance hemodialysis, urea clear index （Kt/V） was 1.2 was protective factor for chronic renal failure patients by maintenance hemodialysis. Conclusion The death cause of chronic renal failure patients were priority to heart disease and cerebrovascular diseases, its death is affected by various factors. In daily work, we can take the corresponding measures to reduce the death rate and improve the prognosis of patients.