摘要
目的系统评价血液透析与腹膜透析方式治疗终末期糖尿病肾病患者的安全性及疗效。方法检索中英文数据库相关资料。检索血液透析与腹膜透析方式治疗终末期糖尿病肾病患者的临床研究,分别从维持透析时间≥6个月出现的并发症,维持透析时间≥3个月血红蛋白水平及透析后6个月、12个月、36个月的存活率进行比较分析。检索年限从建库至2015年12月,使用Rev Man5.3软件对入选临床资料进行Meta分析。结果共检索文献866篇,其中有13篇文献纳入研究。结果 (1)与血液透析相比,终末期糖尿病肾病患者进行腹膜透析发生心脑血管事件及出血并发症的机率较低,差异有统计学意义(P<0.001);而发生感染的机率较高,差异有统计学意义(P=0.05);对于发生营养不良二者无明显统计学差异(P=0.20)。(2)维持透析时间≥3个月血液透析可以更好的改善血红蛋白水平,差异有统计学意义(P<0.05)。(3)维持血液透析与腹膜透析在6个月、12个月、36个月时的存活率均无明显统计学差异(P分别为0.23、0.19、0.53)。结论不同透析方式治疗终末期糖尿病肾病时,进行腹膜透析发生心脑血管事件及出血并发症的机率较低,但容易发生感染;维持透析时间≥3个月则可以显著改善血红蛋白水平;但二者在短期内(36个月)对生存率的影响无明显差别。
Objective：To systematically evaluate the safety and efficacy of the treatment of hemodialysis and peritoneal dialysis for end-stage diabetic nephropathy.Methods：Retrieved related literatures and materials of the domestic and foreign information databases.Retrieved clinical studies of the treatment of hemodialysis and peritoneal dialysis for end-stage diabetic nephropathy, which respectively comparative analyzed complications after maintaining dialysis for 6 months or more, the levels of hemoglobin after maintaining dialysis for 3 months or more and the survival rates at 6、12、36 months after dialysis.Those clinical datas above were selected from the year of database foundation to December 2015, which were meta analysis using RevMan5.3 software.Results：866 related literatures were collected, in which 13 literatures were in accordance with the criteria.Results：① End-stage diabetic nephropathy patients with the treatment of peritoneal dialysis had a lower incidence of cardiocerebral vascular event and bleeding complication than those of hemodialysis, the difference above was statistically significant（P 〈0.001）,However, had a higher incidence of infection（P =0.05）;While in the term of the incidence of malnutrition, these two forms of dialysis had no significant statistical difference（P=0.20）.② Hemodialysis could better improve the levels of hemoglobin than peritoneal dialysis after 3 months or more, the difference above was statistically significant（P 〈0.05）.③The survival rates at 6、12、36 months after these two forms of dialysis had no significant statistical difference（P=0.23, 0.19, 0.53 respectively）.Conclusions：In the aspect of these two forms of dialysis in treating end-stage diabetic nephropathy patients, peritoneal dialysis had a lower incidence of cardiocerebral vascular event and bleeding complication than hemodialysis,but happened infection more easily.Hemodialysis could better improve the levels of hemoglobin than peritoneal dialysis after 3 months or more.And the short-term（36 months）survival rate between the two forms had no significant statistical difference.
出处
《泰山医学院学报》
CAS
2017年第2期147-149,共3页
Journal of Taishan Medical College
