血液透析患者长期存活临床探讨

Clinical Investigation on Long Survival of Hemodialysis Patients

目的:探讨血液透析患者长期生存的影响因素。方法:对采用血液透析疗法治疗尿毒症存活≥5年的33例患者,同期35例存活<5年死亡患者进行对照研究,并分析影响生存质量的因素。结果:存活组年龄低于死亡组;存活组糖尿病肾病所占比例低于死亡组;存活组的心血管并发症、感染和出血情况发生率低于死亡组;血浆白蛋白、总胆固醇、HCO3、血钙和血磷两组有显著差异,结论:高龄、糖尿病是影响透析患者长期存活的重要因素;心血管并发症。感染及出血是透析患者的主要死亡原因;低蛋白性营养不良、代谢紊乱是透析患者预后不良的征兆。

Objective: To evaluate the factors that influenced the long survival of hemodialysis patients. Methods: A control study was carried out between 33 uremic patients that accepted hemodialysis therapy and survived more than 5 years (survial group) and 35 patients that accepted hemodialysis therapy and survived less than 5 years (control group). The factors that influenced the life quality of hemodialysis patients were analyzed. Results: The average age of survival group was younger than that of control group; the proportion of diabetic nephropathy in the former was lower than that in the latter; cardiovascular complications, infectious and bleeding instances in the former were less. There were statistical differences between the two groups in plasma albumin, total cholesterol, bicarbinate, serum calcium and phosphate. Conclusion: Senility and diabetes are the important factors that influence the long survival of hemodialysis patients; cardiovascular complications, infectious and bleeding instances are the leading lethal causes of hemodialysis patients; malnutrition with low plasma albumin, metabolic disorder are the premonitors of poor prognosis for hemodialysis patients.