终末期肾脏病维持性血液透析患者鼻出血的危险因素

Risk factors of epistaxis in maintenance hemodialysis patients with end-stage renal disease

目的:探讨终末期肾脏病维持性血液透析(MHD)患者鼻出血的危险因素,为临床鼻出血的早期防治提供依据。方法:回顾性分析诊治的40例终末期肾脏病维持性血液透析合并鼻出血患者的临床资料,并纳入观察组,随机选择40例未合并鼻出血的MHD患者纳入对照组,采用自制《MHD患者一般情况调查表》收集其临床资料,并对鼻出血影响因素进行分析。结果:观察组年龄≥60岁、男性、透析龄≥1年、尿素清除指数(Kt/V)<1.2、合并高血压及鼻腔干燥的比例明显高于对照组,差异有统计学意义(P<0.05);两组在合并糖尿病、鼻中隔偏曲及血小板计数、PT方面比较差异无统计学意义(P>0.05);Logistic回归分析结果显示,Kt/V、高血压、鼻腔干燥是MHD患者合并鼻出血的独立危险因素,差异有统计学意义(P<0.05)。结论:鼻出血是MHD患者的常见并发症,其中透析充分性差、高血压及鼻腔干燥是患者发生鼻出血的独立危险因素。

Objective To investigate the risk factors of epistaxis in maintenance hemodialysis patients with end-stage renal disease,and to provide evidence for early prevention and treatment of epistaxis.Method The clinical data of 40 maintenance hemodialysis(MHD)patients with end-stage renal disease with epistaxis were analyzed retrospectively and included into the observation group.40 MHD patients without epistaxis were randomly selected as the control group,the clinical data of patients with MHD were collected by self-made MHD General Information Questionnaire,and the influencing factors of epistaxis were analyzed.Results The proportion of patients with age≥60,male,dialysis age≥1 year,Kt/V<1.2,hypertension and nasal dryness in the observation group was significantly higher than the control group(P<0.05);There was no significant difference in diabetes mellitus,deviation of nasal septum,platelet count and PT between the two groups(P>0.05);Logistic regression analysis showed that Kt/V,hypertension and nasal dryness were independent risk factors for MHD patients with epistaxis(P<0.05).Conclusion Epistaxis is a common complication in MHD patients,poor dialysis adequacy,hypertension and nasal dryness are independent risk factors for epistaxis.