【摘要】 目的研究进行腹膜透析治疗的161例终末期肾病(ESRD)患者的流行病学、腹膜透析并发症及透析质量的情况,分析本中心腹膜透析的特点及可能原因。方法回顾性收集患者的性别、植管时年龄、住址、医疗费用支付类别、原发病、腹透起始时间及退出时间、并发症等治疗,计算各种并发症的发病率、掉队率(DOR)、腹透治疗时间(TOT)等指标,并与其他腹透中心进行比较。结果植管时年龄为(54.20±14.00)岁,老年病人较多,大于60岁的占44.10%(71例)。慢性肾炎(75.78%)是导致ESRD的最主要原因,糖尿病肾病(18.64%)位居第二。宁波地区医保普及率较高,完全自费患者比例仅占4.97%。漂管率为11.80%,渗漏率6.83%,隧道口感染率3.11%,大网膜包裹率1.86%,腹腔出血率0.62%。本中心腹膜炎感染控制较好,腹膜炎发生率为1:78.72透析月,总的腹膜炎年发生率为0.15次/透析年。共有59例(36.65%)退出腹膜透析,总的TOT为26.80月,历年TOT呈逐年上升趋势,2011年达平均44.70透析月每人。DOR较其他中心报道的数值低,其中2010年DOR仅7.14%。结论以上特点与本中心患者年龄结构偏大,医护人员重视强化无菌操作宣教,坚持电话随访、家访制度,及医疗保险政策逐年改善有关。更多还原

【Abstract】 Objective To investigate the epidemiology,peritoneal dialysis(PD) related complications and dialysis outcomes of 161 patients with end-stage renal disease(ESRD) undergoing PD.Methods The data including gender,age,addresses,types of medical reimbursement,primary disease,PD-related complications,time of PD initiation and drop out were retrospectively analyzed.Each type of PD-related complications rate,drop out rate(DOR),time on therapy(TOT) were calculated and compared with those of patients in other PD centers.Results The mean age of the patients was 54.20 ±14.00 years,and old patients who aged over 60 years accounted for 44.10%.Chronic glomerulonephritis was the most frequent cause of ESRD followed by diabetic nephropathy.Medical insurance cover is relatively common in Ningbo.The number of patients who paid for their own expenses accounted for 4.97%.PD catheter migration rate was 11.80%,peritonitis rate was 1:78.72 patient-months and 0.15 times per patient-year.Total of 59 cases dropped out of PD therapy,and the total TOT was 26.80 months.The time on therapy in those who dropped out of PD increased gradually in each year,while the number of 2011 was 44.70 months.The data of DOR were lower than those of other centers,especially in 2010,which was 7.14%.Conclusions The above characteristics of the patients are related to many factors,including age structure,education and follow-up for patients,and increased expense covered by medical insurance.更多还原