高龄尿毒症患者血液透析的临床探讨

目的:探讨80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85例80岁以上慢性肾衰竭患者的临床效果及死亡原因.结果:血透能有效延缓80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,另外,心血管和感染并发症更少,均有统计学差异(P<0.05),经Cox回归分析进一步表明透析前年龄、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:血液透析是治疗高龄(≥80岁)慢性肾衰竭患者的有效手段.

The Clinical Study of Hemodialysis on Patients Over 80 with Chronic Renal Failure

Objective:To study feasibility and effects on elderly patients (over 80 years old) with chronic renal failure by hemodialysis.Methods:We retrospectively summed up and analysis the clinical effects and death causes of hemodialysis on 85 patients with chronic renal failure.Results:Hemodialysis can effectively long the life of elderly patients (over 80 years old) with chronic renal failure. The main factors of the death are cardiac vascular diseases and infection. Compared with the patients whose life cycle is less than one year, the patients whose life cycle exceeds one year is younger, creatine clear rate and serum albumine higher, anemia improved, nutritional condition better and hemodialysis more sufficient, as well as cardiac vascular complications and infection fewer. Upons Cox proportional hazard analysis, the age before hemodialysis, diabetes,cardiac vascular complications and infection, plasma albume and hemoglobumine levers are independent risk factors. Conclusion:Hemodialysis is an effective way of treating patients over 80 with chronic renal failure.