首次血液透析患者流行病学和人口学特征分析  

Epidemiology of initial hemodialysis patients

作　　者：庞家亮[1] 高静歌 段坤[1] 王凤业[1] 魏崇一[1] Pang Jialiang;Gao Jingge;Duan Kun;Wang Fengye;Wei Chongyi(Department of Blood Purification Center,the First People's Hospital of Xinxiang,Xinxiang 45300,China)

机构地区：[1]新乡市第一人民医院血液净化中心,453000

出　　处：《国际移植与血液净化杂志》2022年第5期13-18,共6页International Journal of Transplantation and Hemopurification

摘　　要：目的探讨首次血液透析患者的流行病学特点和人口学特征。方法收集2018年1月至2021年12月新乡市第一人民医院血液净化中心接受首次血液透析治疗患者的病历资料,包括患者年龄、性别、身高、体质量、医疗付费类别、临床指标、肾脏病病因、并发症、首次透析原因、透析方式、血管通路等。依据年份不同分为四组,分析不同组别之间上述资料的差异。结果首次血液透析患者以男性居多,首次透析年龄集中在50~69岁,付费类别以职工医保为主,进入血液透析时的肾功能水平逐年改善(P<0.05)。原发病占前三位的是糖尿病肾病、慢性肾小球肾炎和高血压肾病,最常见的并发症是贫血、高血压和骨矿物质代谢紊乱,近2年并发心力衰竭的比例有所增高(P<0.05)。首次透析原因2018及2019年以尿毒症为主,2020年及2021年以心力衰竭为主。首次透析行连续肾脏替代疗法的患者逐年增多,使用的血管通路中,临时性中心静脉置管居首位(所占比例为45.5%~70.0%),其次是半永久性中心静脉置管(所占比例为14.0%~30.0%)。结论本中心首次血液透析患者原发病中糖尿病肾病占首位,贫血是最常见的并发症。进入血液透析时的肾功能水平逐年改善,使用的血管通路以临时性中心静脉置管为主。提示应注意慢性肾脏病一体化管理,积极预防和治疗并发症,加强慢性肾脏病患者透析前教育,增加提前建立动静脉内瘘的比例。Objective To explore the epidemiological characteristics of initial hemodialysis patients in a single center.Methods Medical records were collected from the initial hemodialysis patients between January 2018 and December 2021 in the Blood Purification Center of the First People’s Hospital of Xinxiang,including the patients’age,gender,height,weight,medical payment category,clinical indicators,renal disease etiology,complications,reasons for the first dialysis,dialysis methods and vascular access.Patients were divided into four groups according to different years,and the above data of the patients were analyzed.Results The majority of initial hemodialysis patients were male,and the age of initial dialysis was concentrated between 50-69 years old.The payment category'was mainly employee medical insurance,and the level of renal function when entering hemodialysis was improving year by year(P<0.05).The top three primary diseases were diabetic nephropathy,chronic glomerulonephritis and hypertensive nephropathy.The most common complications were anemia,hypertension and bone mineral metabolism disorders(P<0.05).The proportion of complicated heart failure was increased in the past 2 years.The reasons for the initial dialysis in 2018 and 2019 was mainly uremia symptoms,and in 2020 and 2021,heart failure was the main reason.The number of patients receiving continuous renal replacement therapy lor the first time was increasing year by year.Among the vascular access,non-cuffed catheter was the first(45.5%to 70.0%),followed by tunneled cuffed calheter(14.0%to 30.0%).Conclusions Diabetic nephropathy was the leading cause of hemodialysis in our center.Anemia was the most common complication.The renal function level of patients entering hemodialysis was improving year by year,and the vascular access used was mainly non-cuffed catheter.Attention should be paid to the integrated management of chrome kidney disease to actively prevent and treat the complications.

关 键 词：终末期肾脏病 血液透析 流行病学 

分 类 号：R692.5[医药卫生—泌尿科学] R181.3[医药卫生—外科学]