尿毒症维持血液透析并发上消化道症状患者的胃镜诊断及临床分析  

Gastroscopic Diagnosis in Uremia Patients Maintaining Hemodialysis Complicated with Upper Digestive Tract Symptoms and the Clinical Analysis

作　　者：苏畅[1] 何晓凤[2] 沈艳华[2] Su Chang He Xiaofeng Shen Yanhua(Department of Gastroenterology Hemodialysis Center, Chengdu Hospital of Sichuan Provincial General Corps, the Chinese People＇ s Armed Police Force, Chengdu, Sichuan Province, 610041, P. R. China)

机构地区：[1]武警四川总队成都医院消化内科,四川成都610040 [2]武警四川总队成都医院血液透析中心,四川成都610040

出　　处：《西南军医》2017年第4期323-326,共4页Journal of Military Surgeon in Southwest China

摘　　要：目的分析尿毒症维持血液透析并发上消化道症状患者的胃镜诊断及临床特点,评估上消化道出血的风险。方法回顾性分析78例尿毒症维持血液透析并发上消化道症状患者的胃镜诊断及临床资料,比较是否存在上消化道出血特征,分析维持血液透析患者上消化道出血病因及危险因素。结果上消化道出血患者78例占患者总数的38.46%,以胃黏膜糜烂和急性胃黏膜病变为主,其次为胃窦溃疡。出血组与非出血组在肾功能(BUN、Cr)、血钙(Ca^(2+))、凝血酶原时间(PT)、血浆白蛋白(ALB)、幽门螺杆菌(Hp)感染率等指标差异均有统计学意义(P<0.01或P<0.05)。结论尿毒症维持透析患者上消化道黏膜出血性病变可能性较大,肾功能损害、低血Ca^(2+)、Hp感染、营养不良可能是维持性血透患者并发上消化道出血的危险因素,临床医护人员应引起重视,及早干预。Objective To analyze the gastroscopic diagnosis and the clinical features of the uremia patients maintai- ning hemodialysis complicated with upper digestive tract symptoms and to estimate the risk of upper gastrointestinal bleeding. Methods A retrospective analysis was made to maintaining hemodialysis complicated with upper digesti bleeding occurrence, the manifestation features and occurred in 38.46% of the 78 patients, mainly due due to antral gastric ulcer; the difference in BUN, gastroscopic diagnosis and clinical data of 78 uremia patients ve tract symptoms; the possibility of upper gastrointestinal risk factors were analyzed. Results Upper gastrointestinal bleeding to gastric mucosal erosion and acute gastric mucosal lesion, some Cr, Ca2~ , PT, ALB and Hp infection between the patients with bleeding and those with no bleeding was of statistical significance （ P 〈 0. 01 or P 〈 0. 05 ）. Conclusions Uremia pa- tients maintaining hemodialysis are more prone to have upper gastrointestinal mucosa lesions; impairment of renal func- tion, low level of Ca2＋, Hp infection and malnutrition may be the risk factors; more attention and earlier intervention should be made in clinic.

关 键 词：内镜检查 尿毒症 血液透析 消化道症状 

分 类 号：R692.5[医药卫生—泌尿科学]