A Correlative Analysis of the Dropout in 40 Peritoneal Dialysis Patients in the Hospital_West China Medical Journal

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Department of Nephrology,West China Hospital,Sichuan University,Chengdu Sichuan 610041,China;

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Keywords：

腹膜透析; 退出; 死亡; HD

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目的:調查我院腹膜透析患者死亡和轉HD治療的原因及相關影響因素。方法: 收集腹膜透析患者在我院死亡14例,轉HD治療 2 6例;查閱40例患者在我院的完整病歷資料,調查其死亡及轉HD治療的原因及感染病原菌、營養等指標。結果: 14例腹膜透析死亡患者主要原因為肺部感染合并心腦血管疾病及消化道出血,均占(29%,4/14)。643%(9 / 14)的死亡患者HB lt;90 g/L,ALB lt;30 g/l;71.4%(10 / 14)的腹膜透析死亡患者合并鈣磷失調。 26例腹膜透析患者轉HD的首要原因和次要原因分別為腹透相關性腹膜炎(50%,13/26)和透析液引流不暢(42%,11/26)。72.7%透析液引流不暢的腹透患者經影像學診斷漂管,27.3%患者為拔管手術證實網膜堵塞管口。結論: 1.肺部感染性疾病合并合并心腦血管系統及消化系統,為腹膜透析患者死亡的主要原因,與全身營養狀況不良,鈣磷失調有關。 2. 腹膜透析相關性腹膜炎仍為腹膜透析患者退出轉HD治療的主要原因。 3.因透析液引流不暢而拔管為轉HD治療的第二位原因,漂管和網膜阻塞管口為透析液引流不暢的原因。

Citation： GAO Fang,ZHANG Cao,TANG Xiaohong,et al.. A Correlative Analysis of the Dropout in 40 Peritoneal Dialysis Patients in the Hospital. West China Medical Journal, 2009, 24(9): 2344-2347. doi: Copy

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1. National Kidney Foundation.K/OQI clinic practice guidelines for chronic kidney disease: evaluation, classification, and stratification[J]. Am J kidney Dis, 2002,39(supple1):s266.
2. 章慧娣,王偉銘,王建,等.終末期腎病血液凈化住院患者醫院感染分析[J].中國感染與化療雜志,2006,6(4)..
3. 胡必杰,何禮賢,殷少軍,等.上海市18家綜合性醫院院內感染發病的隊列研究[J].中華醫院管理雜志,2006,16:536-539.
4. RAMON PANIAGUA, KANTE, AMATO, EDWARD VONESH, et al.Effects of increased peritoneal clearances on mortality rates in peritoneal dialysis: ADEMX, a prospective randomized, controlled trial[J]. Am Soc Nephrol, 2002,13:1307-1320.
5. STEVINKEL P, CHUNG SH, HEIMBURGER O, et al. Malnutition, inflammation,and atherosclerosis in peritoneal dialysis patients[J]. Perit Dial Int,2001,21(supple3):S157-162.
6. 封建華,張明.尿毒癥合并上消化道粘膜病變的內鏡下表現與臨床分析[J].中國臨床醫學,2008,15(6):858-849.
7. 王英,王梅.終末期腎病患者鈣磷代謝異常與血管鈣化[J].中國血液凈化雜志,2006,5(13):152-154.
8. PIRAINO B, BAILIE GR, BERNARDINI J,et al.Peritoneal dialysis infections recommendations:2005,update[J].Peit Dial Int,2005,25:107-131.
9. 徐海燕,蔡莉莉.腹膜透析早期透析管移位的原因分析和對策[J].解放軍護理雜志,2008,25(11B):49-48.

West China Medical Journal

A Correlative Analysis of the Dropout in 40 Peritoneal Dialysis Patients in the Hospital

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