腹膜透析患者五年生存率临床分析

目的分析研究慢性肾功能衰竭腹膜透析患者透析前年龄、原发病、透析期间医疗费用支出、透析模式、透析并发症等因素对其生存率的影响。方法对286例腹膜透析患者5年存活组和死亡组透析前年龄、原发病、透析期间医疗费用、透析模式及并发症情况进行对比分析。结果腹膜透析患者死亡组（长期腹膜透析生存时间〈5年）透析前年龄〉60岁者多于存活组（长期腹膜透析生存时间〉5年）．原发病为高血压肾病和糖尿病肾病患者多于存活组，参加农保和自费患者多于存活组，选择间歇性腹膜透析（IPD）模式多于存活组，并发腹膜透析相关性腹膜炎、心血管并发症、营养不良、贫血、透析液引流不畅、恶性肿瘤的多于存活组。结论慢性肾功能衰竭腹膜透析患者的生存率与透析前年龄、原发病、医疗费用支出承受能力、透析模式选择、并发症情况密切相关，只有重视〉60岁老年患者，充分透析，加强营养，积极预防和治疗并发症，重视原发病，才能提高腹膜透析患者的长期生存率。

Objective To analyze the influence of the age before dialysis, the primary disease, the cost of medical treatment during the period of dialysis, the dialysis mode and the complications of dialysis on the survival rate of patients with chronic renal failure. Methods A comparative analysis was undertaken through 5-year long records of 286 patients with peritoneal dialysis in terms of age before dialysis, primary disease, medical expenses, dialysis mode and complications during dialysis. Those records were grouped as survival group and death group. Results Of the peritoneal dialysis patients in death group （ long-term peritoneal dialysis survival time〈5years ） , patients over 60-yeas age before dialysis were more than the survival group （ long-term peritoneal dialysis survival time 〉Syears ） , patients with primary disease like hypertensive nephropathy and diabetic nephropathy were more than the survival group, patients participating in agricultural insurance or self-paying were more than the survival group, patients selecting intermittent peritoneal dialysis （ IPD ） model were more than the survival group, patients with related peritonitis, cardiovascular disease, malnutrition, anemia, poor drainage of dialysis fluid and malignant tumors were more than the survival group. Conclusions The survival rate of peritoneal dialysis patients with chronic renal failure is closely associated with the age before dialysis, primary disease , medicalpayingability, dialysis mode selection and complications. In order to improve the long-term survival rate of peritoneal dialysis patients, those over 60 years need sufficient attention, adequate dialysis, nutrition supplement and active prevention and treatment of complications.