血液透析早期死亡原因及危险因素分析  

Causes and Risk Factors in Early Mortality of Hemodialysis patients

作　　者：张文欣[1] 龚智峰[1] 彭小梅[1] 吴潮清[1] 唐盛[1] 黄文坛[1] 徐碧云[1] 

机构地区：[1]广西壮族自治区人民医院广西壮族自治区血液净化治疗中心,530021

出　　处：《临床内科杂志》2008年第2期95-97,共3页Journal of Clinical Internal Medicine

摘　　要：目的了解终末期肾病患者早期死亡的原因和危险因素。方法对我院1997年1月～2006年12月92例开始血液透析后3个月内死亡患者按糖尿病和非糖尿病分组并进行回顾性分析。结果796例终末期血液透析患者中,早期死亡92例(占11.6%),其中糖尿病组患者早期死亡率为31.2%,非糖尿病组患者为7.9%。肺水肿为最常见的透析指征,心血管事件为最常见的死亡原因。两组年龄、血浆白蛋白、内生肌酐清除率比较有显著性差异。两组患者透析前管理率、择期透析率均较低,结论老年、糖尿病患者有更高的早期死亡率,高龄、糖尿病、低蛋白血症、心血管并发症是早期死亡的危险因素,有效的透析前管理和出现严重并发症之前开始透析也许能改善患者的预后。Objective Despite improvements in dialysis therapy, the mortality rate of patients with end stage renal disease （ESRD） has remained high. A relatively high proportion of uremic patients die within three months after the initiation of dialysis treatment. The aim of this study was to evaluate cause and the risk factors in early mortality of diabetic patients and non-diabetic patients. Method Retrospective study of dialysis patients from 1997 to 2006 was conducted. 92 died in three months after initiation. They were divided into diabetic and non-diabetic. Result Total 796 patients were enrolled. 125 of them （ 15.7% ） were diabetic patients ,39 （31.2%） died in three months. 671 （84.3%） were non-diabetic patients,53 died（7.9% ） in three months. The rates of predialysis management and planned dialysis were low in both groups, Fluid lung was the most common indication and heart failure was the most common cause of death in both groups. Diabetic group was significantly younger, lower serum albumin and higher Ccr. Condusion Diabetic nephropathy patients had higher rate of early mortality after initiation dialysis. The predictors for early mortality include age, diabetes, heart insufficiency, low serum albumin. Effective predialysis care and earlier dialytic therapy may be a choice for improving the prognosis.

关 键 词：终末期肾病 糖尿病肾病 血液透析 早期死亡 死亡原因 

分 类 号：R459.5[医药卫生—治疗学]