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目的初步分析尿毒症维持性血液透析患者死亡原因,并探讨其防治对策。方法对我院血液透析中心2000年1月至2005年12月共265例血液透析维持1个月以上的尿毒症患者进行有关临床分析。结果265例患者中死亡40例,其中死于心力衰竭12例,死于脑出血8例,死于重症感染的4例,死亡组患者平均年龄显著大于成活组患者,动脉收缩压及透析期体质量增长率较成活组高,而血清白蛋白,血清总胆固醇,血清肌酐及尿素氮浓度等反映患者营养状态的指标均较成活组低。死亡组患者平均血液透析时间较成活组明显缩短。结论心脏及血管并发症是尿毒症维持性血液透析患者主要的死亡原因。加强患者的健康教育以控制体重的增长,重视血液透析充分性、控制血压、纠正贫血、加强营养支持治疗是预防该类并发症的重要手段。
Objective To analyze the causes of death in maintenance hemodialysis patients with uremia and to discuss the prevention and treatment measures. Methods A total of 265 patients with uremia who maintained hemodialysis for more than 1 month from January 2000 to December 2005 in our hospital were enrolled in the clinical analysis. Results Of the 265 patients, 40 died, of which 12 died of heart failure, 8 died of cerebral hemorrhage and 4 died of severe infection. The mean age of death group was significantly higher than that of survival group, arterial systolic pressure and dialysis stage The rate of mass growth was higher than that of survival group. The indexes reflecting the nutritional status of patients such as serum albumin, serum total cholesterol, serum creatinine and blood urea nitrogen were lower than those in survival group. The average hemodialysis time in the death group was significantly shorter than that in the survival group. Conclusions Cardiac and vascular complications are the major causes of death in maintenance hemodialysis patients with uremia. Strengthening patient health education to control weight gain, emphasizing the adequacy of hemodialysis, controlling blood pressure, correcting anemia, and strengthening nutritional support and treatment are important measures to prevent such complications.