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:调查我院腹膜透析患者死亡和转HD治疗的原因及相关影响因素。方法: 收集腹膜透析患者在我院死亡14例,转HD治疗 2 6例;查阅40例患者在我院的完整病历资料,调查其死亡及转HD治疗的原因及感染病原菌、营养等指标。结果: 14例腹膜透析死亡患者主要原因为肺部感染合并心脑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钙磷失调。 26例腹膜透析患者转HD的首要原因和次要原因分别为腹透相关性腹膜炎(50%,13/26)和透析液引流不畅(42%,11/26)。72.7%透析液引流不畅的腹透患者经影像学诊断漂管,27.3%患者为拔管手术证实网膜堵塞管口。结论: 1.肺部感染性疾病合并合并心脑血管系统及消化系统,为腹膜透析患者死亡的主要原因,与全身营养状况不良,钙磷失调有关。 2. 腹膜透析相关性腹膜炎仍为腹膜透析患者退出转HD治疗的主要原因。 3.因透析液引流不畅而拔管为转HD治疗的第二位原因,漂管和网膜阻塞管口为透析液引流不畅的原因。

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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6.	封建华,张明.尿毒症合并上消化道粘膜病变的内镜下表现与临床分析[J].中国临床医学,2008,15(6):858-849.
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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对策[J].解放军护理杂志,2008,25(11B):49-48.

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,王伟铭,王建,等.终末期肾病血液净化住院患者医院感染分析[J].中国感染与化疗杂志,2006,6(4)..
3. 胡必杰,何礼贤,殷少军,等.上海市18家综合性医院院内感染发病的队列研究[J].中华医院管理杂志,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. 封建华,张明.尿毒症合并上消化道粘膜病变的内镜下表现与临床分析[J].中国临床医学,2008,15(6):858-849.
7. 王英,王梅.终末期肾病患者钙磷代谢异常与血管钙化[J].中国血液净化杂志,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对策[J].解放军护理杂志,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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