维持性血液透析病人10年生存率及影响因素  

10 year survival rate and its influencing factors in maintenance hemodialysis patients

作　　者：郭雪梅[1] 朱朕男 明虹秀 敬雪明[1] 张和平[1] 杨琨 唐金城 敬剑英[1] GUO Xuemei;ZHU Zhennan;MING Hongxiu;JING Xueming;ZHANG Heping;YANG Kun;TANG Jincheng;JING Jianying(Affiliated Hospital of North Sichuan Medical College,Sichuan 637000 China)

机构地区：[1]川北医学院附属医院,四川637000

出　　处：《循证护理》2025年第2期224-228,共5页Chinese Evidence-Based Nursing

基　　金：川北医学院2022年度四川省基层卫生事业发展研究中心科研项目,编号:SWFZ22-C-94;四川省卫生健康委员会科研课题,编号:19ZD006。

摘　　要：目的:探讨维持性血液透析(MHD)病人的10年生存率,分析其影响因素,为提高MHD病人的生存率和生存质量提供依据。方法:选取2012年1月1日—2013年12月31日在川北医学院附属医院血液净化中心行MHD的220例病人,随访至2023年12月31日,分析其生存率、死亡原因,生存曲线的估计采用Kaplan‐Meier法,采用Cox比例风险模型对影响病人预后的因素进行分析。结果:从进入血液透析时开始计算病人1、3、5、10年的累积生存率分别为90.0%、57.0%、40.0%、19.0%,心血管事件、脑血管意外是最常见的死亡原因,多因素Cox分析结果显示,男性、合并糖尿病、透析前收缩压<140 mmHg、首次透析使用临时性静脉管路、透析中低血压是MHD病人死亡的独立危险因素(P<0.05)。结论:MHD病人的预期寿命非常有限,死亡率仍较高,男性、合并糖尿病、透析前收缩压<140 mmHg、首次透析使用临时性静脉管路、透析中低血压是其死亡的独立危险因素。Objective:To investigate the 10‐year survival rate of MHD patients and analyze its influencing factors,so as to provide reference for improving the survival rate and quality of life of MHD patients.Methods:From January 1,2012 to December 31,2013,220 MHD patients in the Blood Purification Center of the Affiliated Hospital of North Sichuan Medical College were selected and followed up until December 31,2023.Kaplan‐Meier method was used to analyze the survival rate,the cause of death,and the estimation of the survival curve,and Cox proportional risk model was used to analyze the factors affecting the prognosis of patients.Results:The cumulative survival rates of 1,3,5 and 10 years were 90.0%,57.0%,40.0%and 19.0%,respectively.Cardiovascular events and cerebrovascular accidents were the most common causes of death.Multivariate Cox analysis showed that male,diabetes mellitus,systolic blood pressure<140 mmHg before dialysis,temporary intravenous line used for the first dialysis,and hypotension during dialysis were independent risk factors for death in MHD patients(P<0.05).Conclusion:MHD patients have a very limited life expectancy and a high mortality rate.Male,diabetes mellitus,pre‐dialysis systolic blood pressure<140 mmHg,temporary intravenous line use for first dialysis,and hypotension during dialysis are independent risk factors for death.

关 键 词：维持性血液透析 生存分析 危险因素 护理 

分 类 号：R47[医药卫生—护理学]