摘要
目的探讨维持性血液透析(MHD)合并糖尿病患者长期血管通路并发症发生对其生存率的影响分析。方法方便选取2016年12月-2020年12月于该院血液净化中心透析时间>3个月的MHD治疗的终末期糖尿病患者68例作为研究对象,以生存时间3年为界定值,将存活时间<3年的患者作为短期生存组(n=23),存活时间≥3年的患者作为长期生存组(n=45),并对所有患者的临床资料进行回顾性分析。结果短期存活组治疗前合并冠心病(34.78%)、慢性充血性心力衰竭(52.17%)、心律失常(65.22%)、脑梗死(26.09%)、脑出血(56.52%)的比例显著高于长期存活组(4.44%、6.67%、15.56%、2.22%、8.89%),差异有统计学意义(χ^(2)=8.881、18.333、17.152、6.981、18.418,P<0.05),老年痴呆(13.04%)的比例显著高于长期存活组(0.00%),但差异无统计学意义(χ^(2)=3.437,P>0.05);其中短期存活组中因心血管并发症致死率为43.48%,较长期存活组致死率明显偏高,差异有统计学意义(P<0.05)。短期存活组患者并发症总发生率39.13%显著高于长期存活组6.67%,差异有统计学意义(χ^(2)=8.917,P<0.05);两组患者中心静脉置管远期发生中心静脉狭窄、血栓形成、感染及并发症总发生率之间对比,差异无统计学意义(P>0.05)。结论短期生存患者治疗前心脑血管并发症发生率较高,心脑血管病并发症是影响患者近期和远期生存率的主要原因,长期血管通路并发症是影响患者生存时间的重要影响因素。
Objective To explore the impact of maintenance hemodialysis(MHD)patients with diabetes with long-term vascular access complications on the survival rate.Methods 68 patients with end-stage diabetes who were treated with MHD in the blood purification center of the hospital from December 2016 to December 2020 who were treated with MHD for more than 3 months were conveniently selected as the research objects.With a survival time of 3 years as the defined value,patients with a survival time of<3 years were regarded as the short-term survival group(n=23),and patients with a survival time of≥3 years were regarded as the long-term survival group(n=45).And retrospectively analyzed the clinical data of all patients.Results The incidence of coronary heart disease(34.78%),chronic congestive heart failure(52.17%),arrhythmia(65.22%),cerebral infarction(26.09%)and cerebral hemorrhage(56.52%)before treatment in short-term survival group was significantly higher than that in long-term survival group(4.44%,6.67%,15.56%,2.22%,8.89%),the difference was statistically significant(χ^(2)=8.881,18.333,17.152,6.981,18.418,P<0.05).The proportion of senile dementia(13.04%)was significantly higher than that of long-term survival group(0.00%),the difference was not statistically significant significance(χ^(2)=3.437,P>0.05).The mortality rate due to cardiovascular complications in the short-term survival group was 43.48%,which was significantly higher than that in the long-term survival group,the difference was statistically significant(P<0.05).The total incidence of complications in the short-term survival group was 39.13%,which was significantly higher than that in the long-term survival group 6.67%,and the difference was statistically significant(χ^(2)=8.917,P<0.05).There were no statistically significant differences in the long-term incidence of central vein stenosis,thrombosis,infection and complications between the two groups(P>0.05).Conclusion The incidence of cardiovascular and cerebrovascular complications was higher in the short
作者
曾洁纯
ZENG Jiechun(Department of Renal Endocrinology,Huidong Hospital,Guangdong Medical University,Huizhou,Guangdong Province,516300 China)
出处
《中外医疗》
2022年第5期37-40,共4页
China & Foreign Medical Treatment
关键词
维持性血液透析
糖尿病
肾脏病
长期血管通路
并发症
生存率
回顾性分析
Maintenance hemodialysis
Diabetes
Kidney disease
Long-term vascular access
Complication
Survival rate
Retrospective analysis
