高龄尿毒症患者维持性血液透析的临床分析

目的探讨高龄尿毒症患者维持性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37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岁以上尿毒症患者的生命，其死亡原因主要为心血管疾病，其次是感染。存活期≥12月与〈12月的患者比较，开始透析前年龄越小，内生肌酐清除率和血浆蛋白水平越高；贫血程度较轻，而透析期间的营养状况越好；透析更充分，心血管并发症和感染越少。均有统计学差异（P〈0．05）。结论分析表明透析前年龄、原发病为糖尿病、透析中发生心血管并发症或感染、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；血液透析是治疗高龄（≥75岁）尿毒症患者的有效手段。

Clinical analysis on maintenance hemodialysis in the senile uremic patients

Objective To study the feasibility and validity of maintenance hemodialysis for the senile uremic patients. Methods Thirty - seven patients above the age 75 with chronic renal failure were treated by hemodialysis. The clinical results and causes of death were retrospectively summarized and analysed. Results Hemodialysis can effectively prolong the life of senile uremic patiens. The main factors of the death were cardiaovascular diseases and in- fection. Among the patients surviving for 12 months or more,the age of beginning hemodialysis were younger, the endogenous creatinine clearance rate and plasma proteins level were higher, the severity of anemia was relatively lighter, while the nutritinal status during dialysis was better and the angiocardiopathy and other complications were fewer as compared with patients surviving for less than 12 months （ P 〈 0.05 ）. Conclusion The 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. Hemodialysis is an effective way of treating patients over the age 75 with chronic renal failure.