摘要
目的研究腹膜透析患者规律性随访与发生并发症的相关性,为临床诊疗及患者管理提供依据。方法采用单中心回顾性分析方法,收集2020年1月至10月期间在南方医科大学附属花都医院随访的212例腹膜透析患者随访数据:患者本人每月到院1次随访为规律性随访好,否则为规律性随访差。规律性随访差56例作为非规律随访组,规律性随访好共156例作为规律随访组;分析两组患者的基本资料和临床数据。计数资料采用χ^(2)检验,计量资料采用独立样本t检验或Wilcoxon秩和检验,相关性使用Spearman秩相关分析。结果非规律随访组的透析月龄44.50(22.00,77.50)个月、教育程度初中以上占比53.57%(30/56)、收缩压(147.84±19.79)mmHg(1 mmHg=0.133 kPa)、心血管事件发生率28.57%(16/56)、呼吸系统疾病发生率10.71%(6/56)均高于规律随访组(均P<0.05);非规律随访组的生活自理能力完全自理占比73.21%(41/56)、操作换液者为本人占比71.43%(40/56)、残余尿量100.00(0.00,300.00)ml、血清白蛋白(33.65±5.14)g/L均低于规律随访组(均P<0.05)。非规律随访组56例患者共发生53例并发症,占94.64%(53/56);发生并发症原因中,心血管事件占比最高,达26.32%(35/133)。相关性分析显示规律性随访与生活自理能力、操作换液者、透析月龄、收缩压、心血管事件、呼吸系统疾病、其他疾病呈负相关(r=-0.176、-0.272、-0.167、-0.196、-0.195、-0.218、-0.159,P=0.011、0.001、0.015、0.004、0.004、0.001、0.021);规律性随访与教育程度、残余尿量、血清白蛋白呈正相关(r=0.141、0.204、0.165,P=0.041、0.003、0.016)。结论在长期行维持性腹膜透析治疗的过程中,加强患者规律性随访对于减少并发症,尤其是心脑血管事件的发生有重要意义。
Objective To study the correlation between regular follow-up and complications in peritoneal dialysis patients,and to provide basis for clinical diagnosis and treatment and patient management.Methods A single-center retrospective analysis method was used.The data of 212 peritoneal dialysis patients who were followed up in Huadu District People's Hospital of Guangzhou from January to October 2020 were collected.Among them,156 patients themselves were followed up once a month,as a regular follow-up group,and other 56 patients with poor regular follow-up as an irregular follow-up group.The basic and clinical data of the two groups were analyzed.χ^(2) test was used for the count data,independent sample t test or Wilcoxon rank sum test was used for the measurement data,and Spearman rank correlation analysis was used for correlation analysis.Results In the irregular follow-up group,the time of dialysis was 44.50(22.00,77.50)months,the education level abovemiddle school accounted for 53.57%(30/56),the systolic blood pressure was(147.84±19.79)mmHg(1 mmHg=0.133 kPa),the incidence of cardiovascular events was 28.57%(16/56),and the incidence of respiratory diseases was 10.71%(6/56),which were higher than those in the regular follow-up group(all P<0.05).In the irregular follow-up group,the complete self-care accounted for 73.21%(41/56),the fluid change by patients themselves accounted for 71.43%(40/56),the residual urine volume was 100.00(0.00,300.00)ml,and the serum albumin level was(33.65±5.14)g/L,which were lower than those in the regular follow-up group(all P<0.05).The 56 patients in the irregular follow-up group had 53 cases of complications,accounting for 94.64%(53/56);among the causes of complications,cardiovascular events accounted for 26.32%(35/133).Correlation analysis showed that regular follow-up was negatively correlated with self-care ability,fluid change operators,time of dialysis,systolic blood pressure,cardiovascular events,respiratory disease,and other diseases(r=-0.176,-0.272,-0.167,-0.196,-0.195,-0.218,-0.159;P=0.011,0.001,0.015,0.004,0.004,0.001,0.021);regular follow-up was positively correlated with education level,residual urine volume,and serum albumin level(r=0.141,0.204,0.165;P=0.041,0.003,0.016).Conclusion During the long-term maintenance peritoneal dialysis treatment,it is of great significance to strengthen the regular follow-up for patients to reduce complications,especially the occurrence of cardiovascular and cerebrovascular events.
作者
苏彩虹
黄丽秋
李红艳
雷莹
杨椹
张云芳
Su Caihong;Huang Liqiu;Li Hongyan;Lei Ying;Yang Shen;Zhang Yunfang(Department of Nephrology,Huadu District People's Hospital of Guangzhou,Southern Medical University,Guangzhou 510800,China)
出处
《国际医药卫生导报》
2022年第8期1057-1061,共5页
International Medicine and Health Guidance News
基金
广州市医学重点学科建设项目(2021-2023)
花都区科技计划项目(20-HDWS-016,21-HDWS-061,20-HDWS-026)。
关键词
腹膜透析
规律性随访
并发症
Peritoneal dialysis
Regular follow-up
Complications
