326例终末期肾病患者维持性血液透析的效果分析  

Analysis of 326 patients with end stage renal disease undergoing maintenance hemodialysis

作　　者：池小铿 郭颖[3] 谭艺真[3] 陈毅华[2] 牛红心[2] 

机构地区：[1]潮州市人民医院肾内科,广东潮州521011 [2]南方医科大学珠江医院肾内科,广东广州510282 [3]南方医科大学珠江医院器官移植中心,广东广州510282

出　　处：《热带医学杂志》2017年第11期1499-1502,共4页Journal of Tropical Medicine

摘　　要：目的分析2009年1月1日至2015年12月31日在南方医科大学珠江医院血液净化中心进行维持性血液透析(MHD)治疗的326例终末期肾病(ESRD)患者的临床数据,并与其他部分较发达国家或地区的数据进行对比,寻找差距,分析原因,提高MHD质量。方法收集患者一般情况、原发病、并发症、生存情况等资料,计算尿素下降率(URR)、单室尿素清除指数(sp Kt/V)和生存率等指标,并与其他中心比较。结果本中心MHD患者男性多于女性,新增MHD患者平均年龄(51.0±16.6)岁;糖尿病肾病(DN)是ESRD和MHD的最主要原因(22.1%),肾小球肾炎位居第二(20.5%),梗阻性肾病第三(13.0%);血红蛋白、透析前血钙、血磷、甲状旁腺激素的达标率分别为33.5%、42.7%、25.3%和19.7%;1、2、3和5年生存率分别为83.0%、78.0%、69.0%和57.0%,心脏疾病为首位死因。结论本中心患者在发病年龄、原发病构成方面有特点,生存率和发达国家或地区相当,透析充分性和并发症控制方面仍有欠缺。Objective To investigate the general situation ,primary diseases ,dialysis adequacy ,complications and survival outcomes of 326 patients with end stage renal disease（ESRD） undergoing maintenance hemodialysis（MHD） in blood purification center of Zhujiang Hospital from January 1st 2009 to December 31st 2015. Methods The data including general situation ,primary pathogenesis ,HD-related complications and survival outcomes were retrospectively analyzed. Urea reduction rate（URR）,single pool urea clearance（spKt/V）and survival rate were calculated and compared with those of patients in other HD centers. Results The number of male patients was more than female patients in our center. The mean age of newly introduced patients was（51.0±16.6）years old. Diabetic nephropathy（DN）which accounted for 22.1%was the single most common cause of ESRD and MHD,followed by glomerulonephritis（GN） accounting for 20.5%. Obstructive nephropathy（13.0%）was the third leading cause of primary diseases in our center. The success rates of Hb, blood calcium before dialysis ,phosphorus and parathyroid hormone were 33.5%,42.7%,25.3%and 19.7%,respectively;1,2 ,3 and 5 years survival rates were 83.0%,78.0%,69.0%and 57.0%,respectively. Heart disease was the first cause of death. Conclusion The patients in our center have characteristics of age of onset and the component of the primary disease,while survival rate is similar to developed countries and regions. There are still lack of control of dialysis adequacy and complications.

关 键 词：终末期肾脏病 维持性血液透析 透析充分性 并发症 生存率 

分 类 号：R692[医药卫生—泌尿科学]