摘要
目的调查腹膜透析患者退出原因并讨论对策。方法分析第二军医大学附属长征医院腹膜透析中心2003年1月—2008年7月112例腹膜透析患者的临床资料和退出原因。结果112例患者退出腹膜透析的主要原因是死亡(65.2%),其次为肾移植(17.0%)、转血液透析(12.5%)、转院(3.6%)及失访(1.8%)。原发病为糖尿病患者的病死率为78.6%(22/28),高血压患者为71.0%(22/31),均显著高于慢性肾炎患者的29.4%(10/34,P值均<0.05),前两者间的差异无统计学意义(P>0.05)。死亡的首位原因是感染(肺部感染和腹腔感染,43.8%),其次为心血管事件(20.6%)、脑血管事件(19.2%)、呼吸系统疾病(5.4%)、消化道出血(4.2%)、肿瘤(1.4%)。转血液透析的主要原因包括透析不充分(42.9%)、腹膜透析相关感染(28.6%)。腹膜透析早期(1年内)转血液透析的主要原因是技术失败(堵管、漂管、渗液等,28.6%)。结论目前腹膜透析患者退出的主要原因是死亡,而导致死亡的主要原因是感染和心脑血管并发症。
Objective To investigate the reasons for patients＇ drop-out from peritoneal dialysis （PD） and to search for the counter measures. Methods The clinical data and reasons for drop-out from PD were analyzed in 112 patient who withdrew from PD from Jan. 2003 to Jul. 2008 in the peritoneal center of Changzheng Hospital. Results The main reason was death （65.2%）, followed in order by renal transplantation （17.0%）, and transferred to hemodialysis （12.5%）; 1.8% patients were lost in follow-up and 3.6% were transferred to other hospitals. The death rate was 78.6% （22/28） in patients with the primary cause being diabetes and was 71.0% （22/31 ）in patients with hypertension, both were significantly higher than that of the chronic nephritis （P〈0.05）. Infection （43.8%, pulmonary and peritoneal） was the top reason for death, followed by cardio-cerebral vascular complications （20.6%）, respiratory diseases （5.4%）, bleeding from the digestive tract （4.2%）, and tumor （1.4 % ）. The reasons for transfer to hemodialysis included insufficient PD （42.9%）, PD associated infection （28.6 % ）, and technique failures （occlusion, leakage, etc, 28.6 % ）. Conclusion The major cause of PD drop- out is death. Infection and cardiocerebrovascular accidents are responsible for most death cases. （Shanghai Med J, 2009, 32： 249-251）
出处
《上海医学》
CAS
CSCD
北大核心
2009年第3期249-251,共3页
Shanghai Medical Journal
关键词
腹膜透析
退出
腹膜炎
Peritoneal dialysis
Drop-out
Peritonitis
