血液透析高龄患者生存状态调查及分析

Survival situation analysis of elderly patients with hemodialysis

目的调查本中心血液透析高龄患者生存状态,了解患者并发症情况及死亡因素。方法选取接受维持性血液透析患者52例,使用SF-36健康调查表调查患者生存质量,检测患者贫血指标、营养指标和炎症指标,统计患者血管通路、并发症情况和死亡情况及死亡因素。结果 23例患者出现贫血症状,45例患者出现营养不良现象,38例患者出现轻微炎症;14例患者选择内瘘,26例患者选择Cuff导管,3例患者选择临时血透导管,9例患者因功能障碍放弃内瘘改用Cuff导管;17例患者死亡,肺部感染和脑梗死是主要致死原因;患者生存质量评分为(85.4±16.5)分;经Cox回归模型分析发现合并糖尿病和透始血红蛋白是影响患者生存质量的主要因素。结论维持性血液透析能延长高龄患者生存时间,改善生存状态。

Objective To investigate the current situation of the elderly patients with hemodialysis and understand complications and the reasons for death. Methods A total of 52 elderly patients with hemodialysis were selected. The survival quality was measured by SF-36,and the anemia indexes,nutritional indexes and inflammation indexes were measured. The vascular access,complications and death rate were discussed. Results There were 23 patients with anemia,45 patients with malnutrition,and 38 patients with inflammation. 14 patients chose intravascular fistula,26 patients chose Cuff catheter,3 patients chose temporary hemodialysis catheter and 9 patients chose Cuff catheter because of failure with intravascular fistula. 17 patients dead and the main reasons were lung infection and stoke. The SF-36 score was（ 85. 4 ± 16. 5）. According to Cox regression analysis,diabetes and hemoglobin were the main factors for the life quality of patients. Conclusion Maintenance hemodialysis can improve the survival time and quality of life in elderly patients with hemodialysis.