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目的:观察糖尿病肾病(DN)维持血液透析患者的并发症发生和死亡情况,调查死亡的相关因素,有效降低临床维持血液透析的DN患者的并发症和死亡发生率。方法:回顾性分析74例维持血液透析的DN患者的资料,根据结局分为DN死亡组(n=29)和DN非死亡组(n=45),调查并发症和死亡发生率,比较两组并发症和临床指标的差异,并进行Logistic回归分析。结果:1年死亡率16.22%(12/74)、2年死亡率25.68%(19/74)、3年死亡率39.19%(29/74)。并发症类型为心血管意外(31.55%)、感染(21.43%)和脑血管意外(13.10%)为主。年龄(OR=1.856,95%CI1.334-2.582)、DN病程(OR=2.354,95%CI1.526-3.631)、BMI(OR=1.659,95%CI1.325-2.077)和合并并发症数量(OR=3.851,95%CI2.310-6.420)是DN患者维持血液透析死亡的独立危险因素。结论:维持血液透析DN患者的并发症发生率和死亡率都非常高,高龄、BMI、DN病程和并发症数量都是死亡的独立危险因素,必须在血液透析前全面评估病情,加强血液透析期间的并发症护理,以有效降低并发症发生率,降低死亡风险。
OBJECTIVE: To observe the occurrence and mortality of diabetic nephropathy (DN) in patients with hemodialysis and to investigate the related factors of death and effectively reduce the complication and mortality of patients with DN in clinical maintenance of hemodialysis. Methods: The data of 74 patients with DN who undergoing hemodialysis were retrospectively analyzed. According to the outcome, the patients were divided into DN death group (n = 29) and DN non-death group (n = 45). Complications and mortality were investigated. Complications and clinical indicators of differences, and Logistic regression analysis. Results: The 1-year mortality rate was 16.22% (12/74), the 2-year mortality rate was 25.68% (19/74) and the 3-year mortality rate was 39.19% (29/74). The main types of complications were cardiovascular accident (31.55%), infection (21.43%) and cerebrovascular accident (13.10%). (OR = 1.856,95% CI1.334-2.582), DN duration (OR = 2.354,95% CI 1.526-3.631), BMI (OR = 1.659,95% CI1.325-2.077) and the number of complications (OR = 3.851,95% CI2.310-6.420) was an independent risk factor for DN patients in maintaining hemodialysis death. CONCLUSION: The morbidity and mortality of patients with maintenance hemodialysis DN are very high. The age, BMI, DN duration and the number of complications are both independent risk factors of death. The condition must be fully evaluated before hemodialysis and the duration of hemodialysis should be strengthened The complications of nursing, in order to effectively reduce the incidence of complications and reduce the risk of death.