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目的 探讨影响糖尿病肾病尿毒症血液透析患者的生活质量及长期存活的各种危险因素及防治方法。方法 观察 5 2例糖尿病肾病尿毒症患者和同期 5 8例非糖尿病肾病患者透析前后的血液生化指标、存活率、死亡原因及并发症。结果 糖尿病肾病组 1年和 2年存活率分别为 82 %和 71%。主要死亡原因是心血管病变 ,其次为感染。影响透析效果的主要并发症是心血管病变 ( 83 % )、高血压 ( 94% )、透析低血压 ( 3 5 % )、感染 ( 61% ) ,与非糖尿病肾病组比较有显著差异。结论 糖尿病肾病尿毒症患者较非糖尿病肾病患者应更早进行血透 ,肌酐清除率 <15ml/min即应透析 ,控制两次透析期间的体重增加 <5 % ,减少透析时血糖波动 ,防治并发症是减少危险因素 ,提高存活率及生活质量的关键
Objective To explore the various risk factors and prevention and treatment methods of quality of life and long-term survival of hemodialysis patients with diabetic nephropathy. Methods Blood biochemical indexes, survival rate, causes of death and complications before and after dialysis were observed in 52 patients with uremia with diabetic nephropathy and 58 with non-diabetic nephropathy in the same period. Results The 1-year and 2-year survival rates of diabetic nephropathy group were 82% and 71%, respectively. The main cause of death is cardiovascular disease, followed by infection. The major complications that affect dialysis are cardiovascular disease (83%), hypertension (94%), dialysis hypotension (35%) and infection (61%), which are significantly different from those of non-diabetic nephropathy group. Conclusion Diabetic nephropathy uremic patients should be hemodialysis earlier than non-diabetic nephropathy patients, creatinine clearance rate <15ml / min that should be dialysis, dialysis control two body weight gain <5%, reducing blood sugar fluctuations during dialysis, prevention and treatment of complications Is to reduce risk factors, improve survival and quality of life the key