终末期糖尿病肾病患者血液透析的临床分析

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目的观察影响终末期糖尿病肾病血液透析患者长期存活率的危险因素及防治方法。方法选取39例终末期糖尿病肾病患者行血液透析治疗,观察治疗前的血肌酐(SCr)、血尿素氮(BUN)、血糖、白蛋白、血压等情况;进行血液透析治疗,比较2年内死亡患者和存活2年以上患者的基础情况以及透析过程中并发症出现情况。结果两组患者初次透析时血肌酐、血尿素氮水平比较差异具有统计学意义(P<0.05),存活2年以上组该值较小,初始肾功能状态较好;透析中常发生的并发症为透析低血压和低血糖,采取透析前补充蛋白、控制血糖以及透析时静脉推注高糖等措施可以预防和纠正并发症。结论糖尿病肾病终末期患者应及早进行血液透析治疗;常见并发症为透析低血压和低血糖,应注意防治。 Objective To observe the risk factors affecting the long-term survival of hemodialysis patients with end stage diabetic nephropathy and its prevention and treatment. Methods Thirty-nine patients with end-stage diabetic nephropathy were treated with hemodialysis. Serum creatinine (SCr), blood urea nitrogen (BUN), blood glucose, albumin and blood pressure before treatment were observed. Hemodialysis was performed to compare the mortality of patients who died within 2 years And survival of more than 2 years in patients with basic conditions and the complications occurred during dialysis. Results The serum creatinine and blood urea nitrogen levels were significantly different between the two groups at the initial dialysis (P <0.05). The survival of the patients in the two groups for more than 2 years was smaller and the initial renal function status was better. The common complication in dialysis was Dialysis of hypotension and hypoglycemia, pretreatment of protein supplementation, control of blood glucose and dialysis of high blood sugar during dialysis and other measures can prevent and correct complications. Conclusion End-stage diabetic nephropathy patients should be treated with hemodialysis as soon as possible. The common complication is dialysis hypotension and hypoglycemia, and care should be taken.
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