一体化管理改善糖尿病肾病血液透析患者生活质量1例  

Improvement of quality of life in a patient with diabetic nephropathy by integrated management

作　　者：余少斌[1] 曾筱茜[1,2] 付平[1] Yu Shaobin;Zeng Xiaoxi;Fu Ping(Kidney Research Institute,Division of Nephrology,West China Hospital,Sichuan University,Chengdu 610041,China;West China Biomedical Big Data Center,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]华西肾脏病研究所四川大学华西医院肾脏内科,成都610041 [2]四川大学华西医院华西生物医学大数据中心,成都610041

出　　处：《中华肾脏病杂志》2023年第4期291-293,共3页Chinese Journal of Nephrology

基　　金：四川省科技支撑计划项目(2021YFS0162);四川大学华西医院学科卓越发展1·3·5工程临床研究孵化项目(2019HXFH067)。

摘　　要：报告1例63岁原发病为糖尿病肾病的维持性血液透析患者。该患者丧失自理能力,全身水肿,伴心力衰竭、重度贫血、营养不良、消化道出血及顽固性高血压。我们采用“多学科交叉协作”及“医患协作”等一体化的管理方法,通过精确控制容量负荷保护残余肾功能,兼顾基础疾病与并发症的治疗,将透析时与透析间期的临床参数相融合,以及将主观临床症状评分与客观指标分析相结合,最终达到了有效控制患者干体重、缓解并发症、改善营养及保护残余肾功能等目的。患者生活质量得到明显改善。A 63-year-old maintenance hemodialysis patient with diabetic nephropathy was reported.The patient was incapacitated,with systemic edema,heart failure,severe anemia,malnutrition,gastrointestinal bleeding,and intractable hypertension.We adopted integrated management methods such as"multidisciplinary collaboration"and"doctor-patient collaboration":by accurately controlling the volume load to protect the residual renal function,taking into account the treatment of underlying diseases and complications,integrating the clinical parameters of dialysis and the interdialysis period,and combining the subjective clinical symptom score with the objective index analysis,the objectives of effectively controlling the dry weight of patients,alleviating complications,improving nutrition and protecting the residual renal function were finally achieved.The quality of life of the patient had been significantly improved.

关 键 词：肾透析 糖尿病肾病 生活质量 干体重 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]