偏远山区终末期肾病患者透析方式选择初探  

Remote mountain areas in end-stage renal disease patients on dialysis modality selection of

作　　者：刘高伦[1] 薛琳[1] 张颖娟[1] 

机构地区：[1]攀枝花市中心医院肾内科,四川攀枝花617067

出　　处：《四川医学》2012年第1期64-66,共3页Sichuan Medical Journal

摘　　要：目的比较偏远山区终末期肾病(ESRD)血液透析(HD)和腹膜透析(PD)患者的生存状况、存活时间及死亡原因,探讨其透析方式的相对最优选择。方法研究对象为2002年1月1日～2008年12月31日期间川西南、滇西北地区的偏远山区ESRD患者新进入透析且年龄≥18岁患者39例。其中HD组患者22例,PD组患者17例。随访至2010年12月31日。中位随访时间为17.9(0.25,51)个月。采取理化检查及问卷调查或电话调查等方式,观察患者血压、血红蛋白(Hb)、血浆清蛋白(ALB)、尿量、Kt/V、心功能、感染次数、存活时间、死亡原因、心理感受等情况。结果两组患者均存在依从性差、透析不充分、心理感受差等状况,差异比较无统计学意义;HD组患者平均生存时间26.4个月,PD组患者平均生存时间38.4个月,两组结果比较差异有统计学意义(P<0.05)。结论偏远山区ESRD患者生存状况堪忧,主要问题为经济原因,其次为交通状况、文化程度,社会及医务工作者应更关注该类人群;从生存时间上来看,PD优于HD,PD或为其相对最佳选择。Objective Comparison of out-of-the-way and a mountainous area with end-stage renal disease（ESRD） in hemodialysis（HD） and peritoneal dialysis（PD） patients survival condition,survival time and cause of death,to explore the relative optimal choice of dialysis modality.Methods The research object for the January 1,2002 to 2008 December 31 date from southwest,Northwest Yunnan out-of-the-way and a mountainous area ESRD patients entering dialysis and above 18 years of age in 39 patients.Among the patients in group HD 22,PD group of 17 patients with.A follow-up to the December 31,2010.The median follow-up time was 17.9 months（0.25,51）.Take physical examination and questionnaire or telephone survey,observation of blood pressure,plasma albumin,hemoglobin,urine volume（ALB）,Kt / V,cardiac function,infection frequency,survival time,cause of death,psychological feelings etc.Results Two groups of patients have medicine from poor,inadequate dialysis,poor psychological status,no significant difference.In the HD group,the average survival time of 26.4 months,patients in the PD group the mean survival time of 38.4 months,there is significant difference between the two groups（P 0.05）.Conclusion Remote ESRD patients survival condition is worrying,mainly for economic reasons,followed by the traffic status,educational level,social and medical workers should pay more attention to the crowd;survival from the time point of view,PD is superior to HD,PD or its relative optimum selection.

关 键 词：偏远山区 血液透析 腹膜透析 透析方式 选择 

分 类 号：R692.5[医药卫生—泌尿科学]