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目的分析老年人慢性肾功能衰竭(慢性肾衰)的临床特征,探讨其治疗策略。方法对680例≥60岁和402例同期住院的<60岁的慢性肾衰患者的临床资料进行临床回顾性分析。结果老年人慢性肾衰的病因明显不同于非老年组,主要是高血压肾病(28.68%)、糖尿病肾病(23.09%)和慢性肾小球肾炎(22.79%)。临床表现多样,以胃肠道症状为主。老年人慢性肾衰患者多同时伴发一种或多种其他系统疾病,并发症主要是感染、心脑血管并发症、营养不良,发生率均明显高于非老年组。老年人慢性肾衰的肾脏替代治疗多接受血液透析治疗(63.23%),11.47%接受腹膜透析治疗,未接受透析或移植者达14.41%。接受血液透析治疗组的心脑血管并发症发生率及因心脑血管并发症死亡率均高于接受腹膜透析治疗组。结论老年慢性肾衰患者具有心脑血管并发症多,感染、营养不良等发生率高,接受透析治疗比例低等特点,应早期诊断及加强综合治疗,腹膜透析在老年人慢性肾衰的治疗中有更多的优势。
Objective To analyze the clinical features of chronic renal failure (chronic renal failure) in the elderly and to explore its treatment strategy. Methods The clinical data of 680 patients with chronic renal failure who were hospitalized ≥60 years and 402 cases in the same period were analyzed retrospectively. Results The causes of chronic renal failure in the elderly were significantly different from those in the non-elderly group, mainly hypertensive nephropathy (28.68%), diabetic nephropathy (23.09%) and chronic glomerulonephritis (22.79%). Various clinical manifestations, mainly gastrointestinal symptoms. Chronic renal failure in elderly patients often accompanied by one or more other systemic diseases, complications are mainly infections, cardiovascular and cerebrovascular complications, malnutrition, the incidence was significantly higher than the non-elderly group. Renal replacement therapy in elderly patients with chronic renal failure were more frequently treated with hemodialysis (63.23%), 11.47% received peritoneal dialysis, and 14.41% did not receive dialysis or transplant. The incidence of cardiovascular and cerebrovascular complications and the mortality due to cardiovascular and cerebrovascular complications in hemodialysis group were higher than those in peritoneal dialysis group. Conclusions Elderly patients with chronic renal failure have many cardiovascular and cerebrovascular complications, such as high incidence of infection and malnutrition, low rate of dialysis treatment, early diagnosis and comprehensive treatment. Peritoneal dialysis should be used in the treatment of chronic renal failure in the elderly There are more advantages.