高龄尿毒症患者血液透析的临床探讨

目的探讨75岁以上慢性肾衰竭患者血液透析的可行性和有效性.方法回顾性总结和分析血液透析治疗41例75岁以上慢性肾衰竭患者的临床效果及死亡原因.结果血透能有效延长75岁以上慢性肾衰竭患者的生命,其死亡原因主要为心血管疾病,其次是感染.成活期≥12月与＜12月的患者比较,开始透析前年龄更小,内生肌酐清除率和血浆蛋白水平更高,贫血程度较轻,而透析期间的营养状况更好,透析更充分,心血管病和感染并发症更少,均有统计学差异(P＜0.05).分析表明透析前年龄、原发病为糖尿病、透析中发生心血管或感染并发症、血浆白蛋白水平、贫血纠正程度等是高龄血液透析患者死亡的独立危险因素.结论液透析是治疗高龄(≥75岁)慢性肾衰竭患者的有效手段.

Clinical Research on Hemodialysis of the Senile Uremic Patients

Objective To probe the feasibility and validity of hemodialysis for the senile patients with chronic renal failure.Methods 41 patients at the age above 75 with chronic renal failure were treated by hemodialysis.The clinical results and causes of death were retrospectively summarized and analyzed.Results The hemodialysis effectively prolong the life of the patients.The causes of death were mainly angiocardiopathies and then infections.Among the patients surviving 12 months or more,the age of beginning hemodialysis were younger,the endogenous creatinine clearance rate and plasma proteins level were higher,the intensity of anemia was relatively lighter,while the nutritional status during dialysis was better and the angiocardiopathy and other complications were fewer than those surviving less than 12 months(P<0.05).Analysis indicated that the age before dialysis,the diabetes as primary disease,the occurrence of angiocardiopathy or secondary infection during dialysis,the plasma albumin level,the correction efficacy of anemia,etc.were independent risk factors on hemodialysis in senile patients.Conclusion Hemodialysis is the effective means to treating the senile patients(at the age of 75 years or over)with chronic renal failure.