中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (07): 455-458.doi: 10.3969/j.issn.1671-4091.2017.07.006

• 临床研究 • 上一篇    下一篇

71例维持性血液透析患者再入院原因分析

徐文峰1,范元硕2,蔡虎志1,陈海莺1,徐琴1,汤毓1   

  1. 1. 湖南中医药大学第一附属医院
    2. 湖南中医药大学2011级中医外科七年制班
  • 收稿日期:2016-12-06 修回日期:2017-05-22 出版日期:2017-07-12 发布日期:2017-07-14

Analysis of readmission causes in 71 maintenance hemodialysis patients

  • Received:2016-12-06 Revised:2017-05-22 Online:2017-07-12 Published:2017-07-14

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摘要： 目的回顾性分析71 例维持性血液透析(maintenance hemodialysis,MHD)患者再入院原因。方法收集2014 年1 月～2015 年12 月再入院的71 例MHD 患者，以同期65 例门诊MHD 患者为对照，比较2 组患者临床资料，探讨再入院原因。结果71 例MHD 患者再入院原因前3 位分别为各类感染(17例，23.94%)、心血管并发症(15 例, 21.13%)、血压控制差(6 例, 8.45%)；两组患者在高龄人数(χ2=4.980, P=0.026)、体质量指数(t=2.915, P=0.004)、尿素清除指数(t=3.953, P＜0.001)、血红蛋白(t=5.714，P＜0.001)、血清白蛋白(t=4.008，＜0.001)、三酰甘油(t=3.821，P＜0.001)、低密度脂蛋白胆固醇(t=2.968，P=0.004)、感染例数(χ2=8.225，P=0.004)、心血管并发症(χ2=4.883，P=0.027)存在统计学差异。其中高龄(OR=2.566，95% CI 1.118～5.890，P=0.026)、低Kt/V (OR=2.610，95% CI 1.157～5.887，P=0.021)、贫血(OR=2.409，95% CI 1.054～5.507，P=0.037)、低蛋白血症(OR=2.634，95% CI 1.177～5.893，P=0.018)是再入院的危险因素。结论重视MHD 患者营养状况，改善贫血，达到透析充分，加强老年MHD 患者管理，积极控制血糖血压等有助于降低住院率。

关键词: 维持性血液透析, 再入院, 危险因素

Abstract: Objective To retrospectively analyze the readmission causes in 71 maintenance hemodialysis (MHD) patients. Methods Seventy-one MHD patients readmitted to the hospital during the period from Jan. 2014 to Dec. 2015 were recruited. Their readmission causes were analyzed by comparison of clinical data with 65 MHD outpatients in the same period. Results The main readmission cause in the 71 MHD patients was infections (17 cases, 23.94%) followed by cardiovascular complications (15 cases, 21.13%) and poor blood pressure control (6 cases, 8.45%). There are statistically differences between the two patient groups in number of elders (χ2=4.980, P=0.026), BMI (t=2.915, P=0.004), Kt/V (t=3.953, P＜0.001), Hb (t=5.714, P＜0.001), serum albumin (t=4.008, P＜0.001), TG (t=3.821, P＜0.001), LDLC (t=2.968, P=0.004), infection (χ2=8.225, P=0.004), and cardiovascular complications (χ2=4.883, P=0.027). The risk factors for readmission were older age (OR=2.566, 95% CI 1.118～5.890, P=0.026), low Kt/V (OR=2.610, 95% CI 1.157～5.887, P=0.021), anemia (OR=2.409, 95% CI 1.054～5.507, P=0.037), and hypoalbuminemia (OR=2.634, 95% CI 1.177～5.893, P=0.018). Conclusion Improvement of nutritional status, anemia, dialysis adequacy, blood pressure and blood glucose control, and the management for elderly patients may be helpful to reduce the hospitalization rate in MHD patients.

Key words: Maintenance hemodialysis, Readmission, Risk factor