维持性血液透析患者并发消化道出血的危险因素分析

摘要

ABSTRACT:Objective To analyze the risk factors in maintenance hemodialysis patients combined with gastrointestinal bleeding.Methods Twenty-three hemodialysis patients with gastrointestinal bleeding were studied as bleeding group.Over the same period,23 hemodialysis patients without bleeding were studied as non bleeding group to compare all clinical indicators between bleeding group and non bleeding group.The vascular access for hemodialysis used by central venous catheterization or arteriovenous internal fistula were compared between bleeding group and non bleeding group.Risks as smoking,drinking,spicy food,gastrointestinal basic diseases,taking non steroidal anti-inflammatory drugs in bleeding group and non bleeding group were investigated.Results The number of patients in bleeding group increased more significantly than that of non bleeding group,47.8% (11/23)vs 21.7% (5/23)(P 0.05).There were significant difference in smoking,drinking,spicy food,gastrointestinal basic diseases between bleeding group and non bleeding group (all P 0.05).Conclusion Central venous catheterization for hemodialysis, anemia, hypoproteinemia, hypocalcemia, bad eating habit, gastrointestinal basic diseases related with gastrointestinal bleeding in hemodialysis patients.%目的：分析维持性血液透析患者并发消化道出血的危险因素。方法血液透析患者并发消化道出血23例（出血组），同期血液透析无出血并发症的患者23例（未出血组），比较两组患者的各项临床指标。调查两组患者使用深静脉置管还是动静脉内瘘进行透析，并比较两组的透析通路间有无差异。调查并比较两组患者有无吸烟、饮酒、进辛辣饮食、消化道基础疾病及非甾体类消炎药（NSAID）服用情况。结果出血组中使用深静脉置管进行血液透析的患者数量高于未出血组，为47．8％（11／23）vs 21．7％（5／23）（P ＜0．05）；出血组的血红蛋白、血细胞比容、血浆白蛋白、血钙水平低于未出血组，差异有统计学意义（均 P ＜0．01）；出血组的血肌酐、尿素氮、血小板计数、凝血酶原时间、部分活化凝血酶原时间与未出血组比较差异无统计学意义（均 P ＞0．05）；出血组在吸烟、饮酒、辛辣刺激饮食、消化道基础疾病与未出血组比较差异有统计学意义（均 P ＜0．01）；NSAID 服用情况两组比较差异无统计学意义（P ＞0．05）。结论使用深静脉置管进行血液透析、贫血、低蛋白血症、血钙低、不良饮食习惯、消化道基础疾病与血液透析患者并发消化道出血有关。