山西省维持性血液透析患者现状调查

张晓华; 李静; 王利华

doi:10.3969/j.issn.1671-4091.2020.03.017

中国血液净化 >

2020 , Vol. 19 >Issue 03: 209 - 212

DOI: https://doi.org/10.3969/j.issn.1671-4091.2020.03.017

血液净化中心管理

山西省维持性血液透析患者现状调查

张晓华 ,
李静 ,
王利华

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1山西医科大学第二医院肾内科
2山西省卫生计生委医疗质量控制管理中心血液净化质量控制中心

收稿日期: 2019-12-12

修回日期: 2020-01-11

网络出版日期: 2020-03-12

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Epidemiological investigation of maintenance hemodialysis patients in Shanxi province

ZHANG Xiao-Hua ,
LI Jing ,
WANG Li-Hua

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1 Department of Nephrology, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China; 2 Department of Blood Purification Quality Control, Center of Medical Quality Control of Shanxi province, Taiyuan 030001, China

Received date: 2019-12-12

Revised date: 2020-01-11

Online published: 2020-03-12

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摘要

【摘要】目的对山西省维持性血液透析(maintenance hemodialysis，MHD)患者的现状进行调查并分析。方法回顾分析2015 年1 月～2018 年12 月山西省所有开展血液净化治疗的医疗机构网上直报的MHD 患者的病例资料。结果2015～2018 年新进入血液透析患者开始透析年龄主要集中在40～69岁。新进入透析患者原发病因居前3 位的分别是慢性肾小球肾炎2462 例占48.6%，糖尿病肾病1413 例占27.9%，高血压肾损害516 例占10.2%。新进入血液透析的患者血管通路，自体动静脉内瘘居第1 位，共2576 例(占49.8%)，其次是无隧道和涤纶套的透析导管2162 例(占41.8%)。血白蛋白、尿素下降率(urea reduction ratio,URR)及尿素清除指数(Kt/V)达标率均在80%以上，血钙、血磷、血清全段甲状旁腺激素达标率均偏低，不足60%。心脑血管事件是血液透析患者死亡的主要原因。结论山西省MHD 患者以中老年人群为主。血液透析患者前3 位原发病因依次为慢性肾小球肾炎、糖尿病肾病、高血压肾损害。首次透析时的血管通路以自体动静脉内瘘占的比例最高。各项并发症的控制达标率偏低。

关键词： 维持性血液透析; 原发病因; 血管通路; 并发症; 死亡原因

本文引用格式

张晓华 , 李静 , 王利华 . 山西省维持性血液透析患者现状调查[J]. 中国血液净化, 2020 , 19(03) : 209 -212 . DOI: 10.3969/j.issn.1671-4091.2020.03.017

Abstract

【Abstract】Objective To investigate and analyze the current situation of maintenance hemodialysis (MHD) patients in Shanxi province. Methods We retrospectively studied clinical records of MHD patients in Shanxi province between January 2015 and December 2018. Results From 2015 to 2018, the age at which MHD begins was 40 to 69 years. The top three primary causes leading to MHD were glomerulonephritis (48.6%), diabetic nephropathy (27.9%) and hypertensive nephrosclerosis (10.2%). The first-used vascular access at the beginning of hemodialysis was arteriovenous fistula (49.8%) and primary non- cuffed catheter

(41.8%). Albumin, urea reduction ratio (UUR) and urea removal index (Kt/V) reached to the standards were found in more than 80% of the patients, but serum calcium, phosphorus and intact parathyroid hormone reached to the standards were low(<60%). Cardiovascular and cerebrovascular events were the leading causes of death. Conclusion Most MHD patients in Shanxi province were middle- aged. The first three primary causes of MHD patients were glomerulonephritis, diabetic nephropathy, and hypertensive nephrosclerosis. The major vascular access at the beginning of hemodialysis was arteriovenous fistula. The control rate of complications was low in MHD patients.

Key words： Maintenance hemodialysis; Primary cause; Vascular access; Complication; Cause of death

参考文献

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