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目的调查维持性血液净化患者病因构成及治疗状况。方法选取2012年1月-2016年1月300例在杭州市中医院血液净化中心进行维持性血液净化患者作为调查对象,通过查询病历和问卷调查,了解并掌握患者病因、并发症和治疗情况。结果发病原因构成前五位分别为:慢性肾小球肾炎135例(45.0%)、糖尿病肾病54例(18.0%)、高血压肾病42例(14.0%)、梗阻性肾病18例(6.0%)、间质性肾炎15例(5.0%)。并发症:高血压263例、心力衰竭165例、上消化道出血28例、贫血279例、尿毒症脑病发作66例、肾性骨病152例、继发性甲状旁腺功能亢进96例、钙磷代谢紊乱243例。农合保险、自费患者每周血液透析滤过时间明显低于省级医保、市级医保患者;自费患者每周透析频次、血液透析、血液滤过时间均低于省级医保、市级医保、农合保险患者。结论维持性血液净化患者原发疾病主要以慢性肾小球肾炎为主,并发症达标率较低,保险以市级医保为主,自费患者因经济压力大而减少治疗时间。
Objective To investigate the etiology and treatment of patients with maintenance blood purification. Methods From January 2012 to January 2016, 300 patients undergoing maintenance blood purification in the Blood Purification Center of Hangzhou Traditional Chinese Medicine Hospital were selected as the investigation objects. The etiology, complications and treatment of the patients were studied and analyzed through querying medical records and questionnaires. Results The top five causes were chronic glomerulonephritis in 135 (45.0%), diabetic nephropathy in 54 (18.0%), hypertensive nephropathy in 42 (14.0%) and obstructive nephropathy in 18 (6.0%), , 15 cases of interstitial nephritis (5.0%). Complications: 263 cases of hypertension, heart failure in 165 cases, upper gastrointestinal bleeding in 28 cases, 279 cases of anemia, uremic encephalopathy 66 cases, 152 cases of renal osteodystrophy, 96 cases of secondary hyperparathyroidism, calcium 243 cases of phosphorus metabolism disorders. Agricultural insurance, patients with their own weekly hemodialysis filtration time was significantly lower than the provincial health insurance, municipal Medicare patients; patients with weekly dialysis frequency, hemodialysis, hemofiltration were lower than the provincial health insurance, municipal health insurance, Agricultural insurance patients. Conclusions The main diseases of maintenance blood purification patients are mainly chronic glomerulonephritis, and the complication rate is low. The insurance is mainly municipal health insurance, and patients with exacerbation costs reduce the treatment time due to the economic pressure.