论文部分内容阅读
目的:调查我院腹膜透析患者死亡和转HD治疗的原因及相关影响因素。方法:收集腹膜透析患者在我院死亡14例,转HD治疗2 6例;查阅40例患者在我院的完整病历资料,调查其死亡及转HD治疗的原因及感染病原菌、营养等指标。结果:14例腹膜透析死亡患者主要原因为肺部感染合并心脑血管疾病及消化道出血,均占(29%,4/14)。64.3%(9/14)的死亡患者HB<90 g/L,ALB<30 g/l;71.4%(10/14)的腹膜透析死亡患者合并钙磷失调。26例腹膜透析患者转HD的首要原因和次要原因分别为腹透相关性腹膜炎(50%,13/26)和透析液引流不畅(42%,11/26)。72.7%透析液引流不畅的腹透患者经影像学诊断漂管,27.3%患者为拔管手术证实网膜堵塞管口。结论:1.肺部感染性疾病合并合并心脑血管系统及消化系统,为腹膜透析患者死亡的主要原因,与全身营养状况不良,钙磷失调有关。2.腹膜透析相关性腹膜炎仍为腹膜透析患者退出转HD治疗的主要原因。3.因透析液引流不畅而拔管为转HD治疗的第二位原因,漂管和网膜阻塞管口为透析液引流不畅的原因。
Objective: To investigate the causes and related factors of death and HD in our peritoneal dialysis patients. Methods: 14 cases of peritoneal dialysis patients died in our hospital and 26 cases were switched to HD treatment. The complete medical records of 40 patients in our hospital were collected. The causes of death and HD-treatment and the pathogens, nutrition and other indicators of infection were investigated. Results: The main cause of death from peritoneal dialysis in 14 patients was pulmonary infection with cardiovascular and cerebrovascular diseases and gastrointestinal bleeding, accounting for 29% (4/14). 64.3% (9/14) died of HB <90 g / L, ALB <30 g / l; 71.4% (10/14) died of peritoneal dialysis combined with calcium and phosphorus disorders. The primary and secondary causes of HD in 26 patients with peritoneal dialysis were peritoneal dialysis (50%, 13/26) and dialysate (42%, 11/26), respectively. 72.7% dialysate drainage poor peritoneal dialysis patients diagnosed by imaging tube drift, 27.3% of patients extubation confirmed retinal plug nozzle. Conclusions: 1. Pulmonary infectious diseases combined with cardiovascular and digestive system, the main cause of death in patients with peritoneal dialysis, and poor nutritional status, calcium and phosphorus disorders. 2. Peritoneal dialysis-related peritonitis is still the main reason for withdrawal of peritoneal dialysis patients to HD treatment. 3. due to poor dialysis fluid drainage extubation for the second reason for the transfer of HD treatment, bleeder tube and omentum obstruction orifice for dialysis fluid poor drainage reasons.