湛江地区尿毒症防治现况分析

摘要

Objective:To investigate the possible problem of prevention and treatment of uremia in Zhanjiang area,and to provide reference for the diagnosis and treatment of uremia.Method:Specialized service development situation of 12 hospitals with the prevention and treatment of kidney disease were counted in Zhanjiang.173 uremic patients with dialysis ages more than 1 year were inspected randomly,nearly 3 months before dialysis,the levels of systolic pressure(SBP)and diastolic pressure(DBP),hemoglobin(Hb)、blood calcium(Ca)、blood phosphorus(P)and parathyroid hormone(PTH)of the patients were collected and analyzed.Result:1181 maintenance hemodialysis(MHD)patients with dialysis ages more than 1 year and 171 peritoneal dialysis patients were recorded.The temporary venous catheter implantation was carried during 1 year for 1682 times,the ateriovenous fistula surgery and long-term venous catheter implantation were carried during 1 year for 594 times.The levels of SBP、DBP、Ca、P and PTH in most MHD patients were still not up to standard. The relevant index compliance rate in the secondary hospitals compared with tertiary hospitals,there were no statistically significant differences(P>0.05),the detection rates of Hb,Ca,P and PTH in the secondary hospitals were significantly lower than those in the tertiary hospitals,the differences were statistically significant(P<0.05). Conclusion:The secondary prevention of kidney disease in Zhanjiang area is still weak,even if the patient has been replaced by renal replacement therapy,but a large number of patients have not yet reached the standardized diagnosis and treatment,the quality of life of some patients are still poor.%目的：探讨湛江地区尿毒症防治方面可能存在的问题，为规范尿毒症的诊治提供参考。方法：对湛江市地区具有肾病防治专业的12家医院的专科服务开展情况进行统计。随机抽查透析龄大于1年的患者173例，收集患者近3个月透析前收缩压（SBP）、舒张压（DBP）、血红蛋白（Hb）、血钙（Ca）、血磷（P）及甲状旁腺素（PTH）水平进行统计分析。结果：湛江市透析1年以上的维持性血液透析患者共1181例，腹膜透析患者共171例。湛江市各医院1年内开展临时静脉导管置入共1682例次，内瘘手术加长期留置导管置入共594例次。大部分维持性血液透析患者的SBP、DBP、Hb、Ca、P及PTH仍不达标。二级与三级医院患者相关指标达标率比较，差异均无统计学意义（P>0.05）；二级医院的Hb、Ca、P、PTH检测率均明显低于三级医院，差异均有统计学意义（P<0.05）。结论：湛江地区肾脏病的二级预防仍然薄弱，尿毒症患者即使得到了肾脏替代治疗，但大量患者仍未达规范化诊治，部分患者生存质量仍较差。