新增血液透析患者单中心的临床调查  

作　　者：徐春萍[1] 张萍[1] 何永春[1] 严慧娟[1] 郭琦[1] 陈江华[1] 

机构地区：[1]浙江大学附属第一医院肾脏病中心,310003

出　　处：《浙江临床医学》2016年第12期2230-2232,共3页Zhejiang Clinical Medical Journal

基　　金：国家科技支撑计划课题项目（2013BAI09B04）

摘　　要：目的分析血液透析患者的病因特点、肾病病史、血管通路情况，为终末期肾病的筛查、预防、减少患者血管损伤及医疗费用提供依据。方法回顾性分析2012年1月至2014年12月新增血液透析患者的临床资料，收集患者的性别、年龄、原发病、肾病病史、血管通路、透析前血压等数据，分析其临床特征。结果新增首次血液透析患者共776例，男女比例为1．9：1，发病年龄以51-60岁最多。原发病前5位依次为慢性肾小球肾炎、糖尿病肾病、多囊肾、高血压肾病、梗阻性肾病，其中肾小球肾炎占62．4％。患者无明确的肾病病史的有304例（39．2％）。在新进入血液透析时使用的血管通路中，临时导管居第一位，占90．9％，内瘘比例仅占6.4％。第一次透析前75．1％的患者存在收缩压升高。结论新增血液透析患者男性比例高，原发病以肾小球肾炎占首位，39．2％患者透析时才首次就诊，临时导管仍是首次透析的主要血管通路。Objective To analyze the causes and characteristics of hemodialysis patients, the history of renal disease, vascular access, to provide evidence for screening, prevention and reduction of vascular injury and medical expenses of patients with end-stage renal disease. Methods We did retrospective analysis by collecting the clinical data like gender, age, primary disease, duration ofnephrosis, hemodialysisvascular access, blood pressure before hemodialysis and so on from the new hemodialysis in the three years, then analysed their clinical characteristics. Results During 2012- 2014 we received totally 776 hemodialysis patient for the first time treated by hemodialysis, the gender proportion （male to female ） was 1.9 ： 1, the age of onset mostly between51-60years old. The top 5 primary disease were chronicglomerulonephritis, diabetic nephropathy, polycystic kidney disease, hyperpieticnephropathy and obstructive nephropathy, chronicglomerulonephritisaccounted for62.4%. There are 304 patients （ 39.2% ） whose chronic kidney disease historyis not clear. As a treatment of vascular access builtfor the first time, the temporary catheterranked first which accounting for 90.9%, and the proportionof fistula was only6.4%. Before the firstdialysis, 75.1%patients withsystolic blood pressure. Conclusions There were more male new patients during this period, chronicglomerulonephritis ranked the first as a primary disease. 39.2% of patients need hemodialysis at the first clinic, temporary eathetermnked is still the first major vascular access.

关 键 词：血液透析 病因 血压 血管通路 

分 类 号：R459.5[医药卫生—治疗学]