维持性血液透析20年以上者生存质量分析

目的 探讨维持性血液透析20年以上者的生存质量.方法 对接受维持性血液透析治疗20年以上的终末期慢性肾脏疾病患者进行横断面调查,调查内容包括一般情况、贫血、钙磷代谢紊乱、继发性甲状旁腺机能亢进症、微炎症状态、心脏超声等相关检查以及患者生活状况.结果 共纳入5例患者,其中血压高于正常范围者1例.血红蛋白为（113.2±17.7）g/L,透析前血清总蛋白、白蛋白、钾、钠、氯和钙水平均正常,高磷血症3例,血清铁蛋白为43.1～ 1342.5 μg/L[平均（361.1±551.7） μg/L],高敏C反应蛋白为（4.1±4.3）mg/L,全段甲状旁腺激素为40～904 ng/L,Kt/V为1.1～2.2（平均1.5±0.4）.患者均已出现心脏结构及功能异常.生活完全自理者3例,均与亲属关系和睦.对生活现状满意和较满意者2例,存在躯体症状者3例.结论 终末期慢性肾脏疾病患者通过血液透析治疗能够得以长期、高质量地存活.

Quality of life of patients treated with maintenance hemodialysis for more than twenty years

Objective To explore the quality of life in end-stage renal disease patients undergoing maintenance hemodialysis treatment for more than twenty years. Methods A clinical transeetional study was performed in end-stage renal disease patients treated with maintenance hemodialysis for more than twenty years. General condition, hemoglobin, calcium phosphate product, intact parathyroid hormone （iP13-I）, high sensitive C reactive protein （HS-CRP） and echocardiography were recorded in these patients. Results Among the five patients, only one had hypertension. Mean hemoglobin level was （113.2 ＋ 17.7） g/L, and total protein, albumin, potassium, sodium, chlorine and calcium were normal. Higher serum phosphate level was found in three patients. Ferritin was 43.1-1342.5 ~g/L （mean （361.1 -＋ 551.7） ~g,/L）, average HS-CRP was （4.1 _ 4.3） rag/L, iPl~l was 40-904 ng/L, and Kt/V was 1.1-2.2 （ 1.5 -＋ 0.4）. The cardiac structure and function was changed. Three patients were self-cared and enjoyed family rapprochement, two patients were satisfied with their life, and three patients had physical symptoms. Conclusion End-stage renal disease patients may maintain good quality of life through maintenance hemodialysis treatment.