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目的 :探讨维持性血液透析(MHD)患者再住院的原因及相关因素分析。方法 :选择我院血液净化中心接受MHD治疗的患者126例,其中反复住院者52例为实验组,未住院或住院≤1次/年患者74例为对照组。记录患者住院次数、住院原因、性别、年龄、透析龄、维持血透的血管通路、透析前血清电解质、尿素氮、肌酐、血红蛋白(Hb)、血清白蛋白(Alb)、C反应蛋白和平均周kt/v等。结果 :实验组中老年人,糖尿病肾病患者再住院率高,与对照组比较,差异有统计学意义,低白蛋白血症、贫血、高C反应蛋白、低平均周kt/v与患者再住院相关,血液透析的血管通路为导管者较血管通路为动静脉内瘘者住院率明显增加。结论 :心脑血管疾病、感染、血管通路问题是维持性血透患者反复住院的主要原因,其低蛋白血症、贫血、高C反应蛋白、透析不充分是再住院的相关因素,以导管为血管通路增加了感染和住院的风险。
Objective: To investigate the causes and related factors of rehospitalization in maintenance hemodialysis (MHD) patients. Methods: One hundred and sixty-six patients with MHD who were treated by our hospital’s blood purification center were enrolled in this study. Among them, 52 cases of recurrent hospitalization were experimental group, 74 cases were hospitalized or ≤1 hospitalized per year as control group. The number of hospitalizations, hospitalization, sex, age, dialysis age, hemodialysis vascular access, pre-dialysis serum electrolytes, urea nitrogen, creatinine, hemoglobin (Hb), serum albumin (Alb), C-reactive protein kt / v and so on. Results: The rehospitalization rate of middle-aged and diabetic nephropathy patients in the experimental group was significantly higher than that in the control group. Hypoproteinemia, anemia, high C-reactive protein, low mean kt / v and rehospitalization Related, hemodialysis vascular access catheter for vascular access for arteriovenous fistula hospitalization rate was significantly increased. Conclusions: Cardiovascular and cerebrovascular diseases, infections and vascular access are the main reasons for repeated hospitalization of maintenance hemodialysis patients. The hypoproteinemia, anemia, high C-reactive protein and inadequate dialysis are the related factors of rehospitalization. Vascular access increases the risk of infection and hospitalization.