国际移植与血液净化杂志
國際移植與血液淨化雜誌
국제이식여혈액정화잡지
INTERNATIONAL JOURNAL OF TRANSPLANTATION AND HEMOPURIFICATION
2013年
3期
29-32
,共4页
糖尿病肾病%血液透析%一体化治疗
糖尿病腎病%血液透析%一體化治療
당뇨병신병%혈액투석%일체화치료
Diabetic nephropathy%Hemodialysis%Intergration treatment
目的 调查新入血液透析糖尿病肾病患者临床情况,了解慢性肾病患者一体化治疗情况及其影响因素.方法 选择我院8年来新入血液透析的糖尿病肾病患者125例,按其进入血液透析前是否接受专科治疗分为A、B组,A组为非专科治疗组,B组为专科治疗组,比较其来源、文化程度、尿毒症危害知晓率、发现肾脏至血液透析时间、治疗情况、首次血液透析的生化指标及并发症.结果 A组患者在肾脏病危害知晓率、文化程度方面明显低于B组,农村来源人口较B组多,发现肾功能不全至开始透析时间A组患者明显短于B组(P＜0.05)；A组贫血、代谢性酸中毒、钙磷代谢紊乱、低白蛋白血症明显,急诊透析多,血压控制不理想,与B组患者比较差异有统计学意义(均P＜0.05).A组患者在优质低蛋白饮食+α酮酸治疗、肾性贫血纠正、甲状旁腺激素监测、钙磷平衡调节、血压控制等方面不及B组患者(均P＜0.05).结论 糖尿病肾病的一体化治疗尚未到位,主要与随诊医生、患者文化程度及来源等有关.今后需加强公众宣传及健康教育,敦促患者早期接受专科治疗.
目的 調查新入血液透析糖尿病腎病患者臨床情況,瞭解慢性腎病患者一體化治療情況及其影響因素.方法 選擇我院8年來新入血液透析的糖尿病腎病患者125例,按其進入血液透析前是否接受專科治療分為A、B組,A組為非專科治療組,B組為專科治療組,比較其來源、文化程度、尿毒癥危害知曉率、髮現腎髒至血液透析時間、治療情況、首次血液透析的生化指標及併髮癥.結果 A組患者在腎髒病危害知曉率、文化程度方麵明顯低于B組,農村來源人口較B組多,髮現腎功能不全至開始透析時間A組患者明顯短于B組(P＜0.05)；A組貧血、代謝性痠中毒、鈣燐代謝紊亂、低白蛋白血癥明顯,急診透析多,血壓控製不理想,與B組患者比較差異有統計學意義(均P＜0.05).A組患者在優質低蛋白飲食+α酮痠治療、腎性貧血糾正、甲狀徬腺激素鑑測、鈣燐平衡調節、血壓控製等方麵不及B組患者(均P＜0.05).結論 糖尿病腎病的一體化治療尚未到位,主要與隨診醫生、患者文化程度及來源等有關.今後需加彊公衆宣傳及健康教育,敦促患者早期接受專科治療.
목적 조사신입혈액투석당뇨병신병환자림상정황,료해만성신병환자일체화치료정황급기영향인소.방법 선택아원8년래신입혈액투석적당뇨병신병환자125례,안기진입혈액투석전시부접수전과치료분위A、B조,A조위비전과치료조,B조위전과치료조,비교기래원、문화정도、뇨독증위해지효솔、발현신장지혈액투석시간、치료정황、수차혈액투석적생화지표급병발증.결과 A조환자재신장병위해지효솔、문화정도방면명현저우B조,농촌래원인구교B조다,발현신공능불전지개시투석시간A조환자명현단우B조(P＜0.05)；A조빈혈、대사성산중독、개린대사문란、저백단백혈증명현,급진투석다,혈압공제불이상,여B조환자비교차이유통계학의의(균P＜0.05).A조환자재우질저단백음식+α동산치료、신성빈혈규정、갑상방선격소감측、개린평형조절、혈압공제등방면불급B조환자(균P＜0.05).결론 당뇨병신병적일체화치료상미도위,주요여수진의생、환자문화정도급래원등유관.금후수가강공음선전급건강교육,돈촉환자조기접수전과치료.
Objective To survey the clinical situation of the newly hemodialysis patients with diabetic nephropathy,and to understand the effectiveness of integration treatment on diabetic nephropathy.Methods A total of 125 patients with diabetic nephropathy who newly underwent hemodialysis in our hospital in the past eight years were enrolled in this study.The subjects were then assigned to two groups:group A was not followed up by renal specialists,group B was followed up by renal specialists.Patients'sources,level of education,awareness of uremia and time from onset of kidney disease to hemodialysis,treatment,biochemical indicators of the first hemodialysis and complications were compared between the two groups.Results In comparison with group B,the patients of group A showed lower disease awareness and level of education and reduced duration from discovering kidney disease to hemodialysis.Anemia,metabolic acidosis,calcium and phosphorus metabolism disorder,hypoalbuminemia,emergency dialysis and blood pressure control were significantly different between the two groups (all P ＜ 0.05).In some aspects,such as low protein diet+ compound keto acid treatment,correcting renal anemia,monitoring parathyroid hormone,regulating the balance of calcium and phosphorous,and controlling blood pressure,the group A was worse than group B (all P ＜ 0.05).Conlusions The integrated treatment of diabetic nephropathy is not yet in place,mainly related with follow-up investigators and patient's level of education,etc.Public propaganda,health education and early intervention should be strengthened.
