利用ASPmaker快速开发中国透析移植学会(CDTA)网站

以中国透析移植学会网站开发过程为例,介绍利用ASPmaker快速开发基于ASP技术医学网站的方法。ASPmaker的应用,不仅加快了ASP网站开发过程,而且降低了技术难度,使广大医务工作者也能参与医学网站的开发建设。

尿毒症患者无透析肾移植与透析后肾移植的临床效果比较

目的:观察尿毒症患者未经透析直接行肾移植的临床疗效,并与透析后肾移植患者比较,探讨无透析肾移植的临床可行性。方法:回顾性总结2001年1月至2004年7月间本研究所完成的128例无透析尸肾移植的尿毒症患者临床资料,并与同期施行的569例透析后尸肾移植患者的临床资料进行对比分析。结果:无透析肾移植组术前肝炎病毒感染率显著低于透析后肾移植组(4.69%vs18.45%,P<0.05)。无透析肾移植组术后肌酐恢复正常时间平均为(7.26±5.49)d,透析后肾移植组为(8.37±4.76)d,两组无显著差异。术后1个月无透析肾移植组血红蛋白和白蛋白水平分别为(96.67±23.54)g/L和(40.28±8.53)g/L,透析后肾移植组分别为(92.17±21.83)g/L和(38.34±7.84)g/L,两组无显著差异。无透析肾移植组术后急性排斥发生率显著低于透析后肾移植组(19.53%vs34.27%,P<0.05),感染发生率与透析后肾移植组则无统计学差异(28.13%vs36.38%,P>0.05)。无透析肾移植组人/肾1年存活率均为98.44%,人/肾3年存活率均为96.23%,透析后肾移植组人/肾1年存活率为97.72%/95.96%,3年存活率为94.4%/88%,两组间无显著差异。结论:无透析肾移植避免了透析的并发症和输血致敏,降低了肝炎感染的风险,降低术后急性排斥的发生率,人/肾存活率与透析后移植相当,在临床上具有可行性。

肾移植术前血液透析的风险因素分析及护理对策

肾移植术前血液透析存在一定的风险,在进行手术前采取护理措施能够更好的应对风险,降低对患者安全的影响,提高手术治疗效果。方法 以我院收诊的120例肾移植术前血液透析患者为研究对象。结果 护理后对照组的生活质量评分低于观察组。护理后对照组的焦虑与抑郁评分高于观察组。对照组护理满意度低于观察组。结论 肾移植患者手术后容易出现较多的风险,若是不注意可能会出现手术失败情况,肾移植患者手术前进行血液透析要做好准备,降低对患者身体的影响,尽量的做好手术前准备工作,做好护理管理工作,采取针对性护理措施后患者的恢复情况更好,发生护理的风险降低,情绪更为稳定,有推广的价值。

1999年度北京市透析移植登记报告

patients were registered in 1999 from 66 hospitals in Beijing, including 3 362 hemodialysis(HD) cases(91% )and 314 peritoneal dialysis(PD) cases(9% ). Of them 1 966 cases received dialysis newly within 1999. Median age was 54 in HD and 62 in PD. There were 655 HD machines. 97% dialysate belonged to bicarbonate. 69 835 dialysers had been used and mean time of reuse was 5. 3 times. The consumption of synthesis membrane dialysers increased from 36% in 1998 to 49% in 1999. 95% patients underwent HD with autologous arteriovenous fistula. There were 19 hospitals with PD patients in 1999. 307/314(98% ) cases received CAPD therapy. Twin bag set accounted for 82% in PD connection in 1999, as compared to 0% in 1998. Baxter PD dialysate was commonly used in 18 hospitals. Catheters of 74% patients were Tenckhoff, 24% patients Swanneck. Incidence of peritonitis was 0. 1 patient per year. In patients who received dialysis adequate evaluations, 17% HD cases were inadequate. The levels of hematocrit in all the patients with erythropoietin treatment were below normal. Until 1999. 12. 31, 1 909/3 676 dialysis patients survived accounting for 52%. The longest dialysis duration was 9. 5 years. The first cause of dialysis was glomerulonephritis (40%), then diabetic nephropathy( 11%) . 3% HD and 6% PD patients presented abnormal SGPT. 5% HD and 6% PD patients possessed positive HBV markers. 7% HD and 4% PD cases possessed positive HCV markers. Total mortality of dialysis patients was 9% in 1999; of HD 8% and of PD 13. 4% respectively. The first cause of death was cardiac factor. 14% dialysis patients underwent renal transplantation.

1999年度辽宁省透析移植登记报告

There were 3 474 dialysis patients and their average age was 49. 1 years. The first primary disease was glomerulonephritis (38. 1%), then diabetic nephropathy (17. 6%) . There were 360 HD machines. 15511 dialysers were used in 1999. 99% dialyser were imported, of them hemophan membrane accounted for 60%. The longest dialysis duration was 16 years. 382 (13. 1% ) cases died. The main death causes were cardiovascular disorder (38. 1% ) and cerebrovascular disorder (24. 2%). 12. 8% patients died of dialysis interruption automatically. Positive HBV markers were found in 8. 1% HD and 4. 9% PD cases. Positive HCV markers were found in 4. 7% HD and 2. 7% PD cases. 6. 0% HD and 9. 0% PD patients presented abnormal SGPT. Incidence of peritonitis was one time per 28 patient months. A great part of patients was inadequate and their hematocrit levels were below normal. Until 1999. 12. 31, 1 157 patients had received renal transplantation and the survival rate was 61. 7%.

1999年度广东省透析移植登记报告

There were 475 hemodialysis (HD) machines in 50 hospitals providing HD treatment and 1 7of above 50 offered peritoneal dialysis (PD) as well. Dialysers were reused by manual wash methods in 94% HD units and mean reuse time was 5. 2 times for import dialysers, 4. 3 times for local ones. 88. 2% patients received CAPD and 59% cases used twin bag set. Baxter peritoneal dialysate and Tenckhoff catheter were applied to 94% and 99% PD units respectively. 2 5 18/2 618 (96. 2% ) patients with permanent vessels received autogolous arteriovenous fistula. There were 3 357 HD cases in 1999 including 1 664 new cases within 1999. Until 1999. 12. 31, 2 099 patients survived. There were 415 PD cases in 1999 including 148 new cases within 1999. Until 1999. 12. 31, 347 PD patients survived. 432 cases underwent transplantation in 1999. Glomerulonephritis (54. 6%) was still the first primary disease of dialysis, then diabetic nephropathy (13. 1%). Mean URR value of 1106 HD patients was 0.64. Mean Kt/V values of 1 460 HD cases and 320 PD cases were 1. 42 and 1. 75 respectively. With erythropoietin therapy, hematocrit levels of 1064 HD and 222 PD patients were 0. 243 ± 0. 032 and 0. 262 ± 0. 035 respectively. Positive HBV markers were found in 256(12. 1% ) HD patients and 40 (11. 3%) PD patients; positive anti-HCV antibody in 248 (11. 9% HD cases and 18 (5. 1% ) PD cases. 79 peritonitis infections occurred in 415 cases. 88 HD patients, but only one PD patients, survived more than 10 years. 77 acute HD and 161 maintenance HD patients were dead. Cardiac failure and cerebrovascular disorder were main causes of death. 3 acute PD and 25 maintenance PD patients were dead. Organ failure and infection were common causes. Total 266 cases died accounting for 7. 1%. 28 transplantation patients were dead accounting for 6. 5%.

1999年度上海市透析移植登记报告

hospitals were registered in 1999. There were 629 hemodialysis (HD) machines in 59 hospitals providing HD therapy. 37 hospitals offered peritoneal dialysis (PD) treatment. 3 975 HD patients were registered in 1999 including 1 769 new cases within 1999. The annual incidence rate was 135 pmp and point prevalence (1999. 12. 31) was 180 pmp. 670 PD patients were registered in 1999 including 268 new cases within 1999. The annual incidence rate was 20 pmp and point prevalence (1999. 12. 31) was 34 pmp. The first cause of chronic renal failure was glomerulonephritis (61. 0% in HD and 55. 5% in PD respectively), then diabetic nephropathy. Of HD, 369 patients (9. 3% ) were dead; 368 (9. 3% ) underwent renal transplantation and 772 (18. 2% ) left registered hospitals. Of PD, 108 patients (16. 1% ) were dead; 23 (3. 4%) underwent renal transplantation and 42 (6. 3%) left registered hospitals. The first cause of death was cerebrovascular accident in HD and PD. Until 1999. 12. 31, positive HBV markers were found in 14. 1% HD patients and 14. 4% PD patients; positive anti-HCV antibody in 28. 6% HD cases and 8. 0% PD cases. In HD patients, the mean URR value was 0.63 (1 285 cases)and the mean Kt/V was 1. 34 (1 227 cases) . In PD patients, the mean Kt/V value was 1. 7 (347 cases) and the mean weekly Ccr was 58. 2 L week’ (1. 73m2) 1(325 cases). The hematocrit level of all the patients was below normal. 97% patients underwent HD with autologous arteriovenous fistula. 82. 8% patients received CAPD and twin bag set accounted for 52. 8%. 83. 8% hospitals used Baxter peritoneal dialysate and 43. 2% hospitals used peritoneal dialysate produced in Shanghai. Incidence of peritonitis was one time per 41. 4 patient-month in cases with twin bag set. In 1999, there were 10 hospitals providing renal transplantation and 435 patients received transplantation(annual incidence rate 32 pmp) . Until 1999. 12. 31, 2 764 transplantation patients survived totally (point prevalence 210 pmp).

无透析肾移植与透析后肾移植临床效果比较

目的:对比无透析肾移植和血透(HD)及腹透(PD)后肾移植的人/肾存活率、排斥反应发生率、移植肾功能延迟恢复(DGF)的发生率及感染情况。方法:回顾调查无透析肾移植病人50例,随机抽取术前基本情况相仿的HD及PD后肾移植各50例做为对照。结果:无透析组1年、3年人/肾存活率分别为98%/98%,94%/94%;HD组1、3年人/肾存活率分别为98%/96%,94%/90%;PD组1、3年人/肾存活率分别为96%/96%,94%/90%。3组比较无显著性意义(P>0.05)。无透析组急性排斥反应(AR)发生率8%,HD组18%,PD组14%,3组比较无透析组AR发生率明显低于其他2组,有显著性意义(P<0.05)。3组慢性排斥反应(CR)发生率均为4%,相比较无显著性意义(P>0.05)。无透析组DGF发生率10%,HD组22%,PD组18%。无透析组DGF发生率明显低于其他2组,有显著性差异(P<0.05)。无透析组术后巨细胞病毒(CMV)感染率为12%,HD组14%,PD组10%,3组比较无显著性差异(P>0.05)。无透析组术后肝炎患者4%,HD组14%,PD组8%,HD组感染率明显高于其他2组,有显著性差异(P<0.05)。结论:满足血肌酐<750μmol/L,血钾<6g/L,24h尿量>1000ml的尿毒症患者直接行肾移植术,安全可行,费用低。

维持性血液透析患者合并微炎症状态的诊治进展

近年来，随着血液透析技术的进步，维持性血液透析（MHD）患者的长期生存率已显著提高，但心脑血管疾病仍是影响患者预后的重要因素。MHD患者心血管疾病病死率是普通人群的30倍，除外年龄、性别、糖尿病等因素影响后仍高达10-20倍。根据1999年全国透析移植登记报告显示，我国透析患者死亡原因主要为心力衰竭和脑血管意外，分别占32％和19％。