维持性血液透析对终末期肾病患者治疗转归及生存率的影响

摘要

Objective To analysis the affects of treatment outcome and survival of maintenance hemodialysis for end‐stage renal disease (ESRD) .Methods A retrospective analysis of 110 cases ESRD patients was per‐formed .The factors of treatment outcomes and survival rate were analyzed .Results One year survival rate was 89.1% ,3 year survival rate was 78 .2% ,5 year survival rate was 60.9% .41.4% patients still received dialysis , 2.7% changed for peritoneal dialysis ,7.7% had kidney transplantation ,9.1% were transferred to other hospi‐tals ,43 cases died(39 .1% ) .Multivariate Cox Regression analysis showed that the first dialysis age ,the number of dialysis ,the nutritional status and residual renal function of the first dialysis had a great impact on the effect of dialysis .Factors for death were cardiovascular events (32 cases) ,infection (7 cases) ,gastrointestinal bleeding (3 cases) ,and hyperkalemia (2 cases) .Conclusion First dialysis age ,the number of dialysis ,the nutritional status and residual renal function of the first dialysis had a great impact on the effect of dialysis in the ESRD patients . Clinical importance should be given to improve the survival rate of patients with ESRD .%目的：评价分析维持性血液透析对终末期肾病患者（ESRD）治疗转归及生存率的影响。方法回顾性分析我院近5年来收治的110例ES RD患者临床资料，并分析本组患者治疗转归情况和生存率情况以及影响因素。结果110例患者1年生存率为89.1％；3年生存率为78.2％；5年生存率为60.9％，随着透析时间的延长生存率呈现下降趋势；仍接受透析者有41.4％，改为腹膜透析者2.7％，肾移植7.7％，转其他医院者9.1％，死亡43例（占39.1％）。Cox回归多因素分析发现，患者首次透析年龄越小、透析次数越多，首次透析营养状况以及残余肾功能越多，则患者生存率越高，病死率越低。其中死亡因素为心脑血管事件32例，感染7例，消化道出血有3例，高钾血症2例。结论患者首次透析年龄、透析次数、首次透析营养状况以及开始透析残余肾功能等是ES RD患者维持性血液透析生存率的重要因素，临床应给予重视，以提高ES RD患者生存率。