曾宇然++谭凤娇++严丽君+林婉敏

[摘要]目的 分析老年初次血液透析患者的临床情况，探讨老年初次血液透析患者的特点。方法 对2013年1月～2015年12月我院新增的185例老年初次血液透析患者的原发病因、并发症、实验室检查结果进行分析。结果 185例老年初次血液透析患者的原发病因以糖尿病肾病（54.6%）、慢性肾小球肾炎（21.1%）、高血压肾病（14.6%）排前三位，严重并发症包括急性左心功能衰竭、严重酸中毒、高钾血症、重度贫血，其发生率分别为34.6%、35.7%、19.5%、20.0%，超过30%的老年初次血液透析患者发生2种及以上的严重并发症。结论 老年初次血液透析患者的病因以糖尿病肾病、慢性肾小球肾炎、高血压肾病为主，患者进入血液透析时常合并严重的并发癥，且发生率高。

[关键词]老年；血液透析；原发病因；并发症

[中图分类号] R459.5 [文献标识码] A [文章编号] 1674-4721（2017）11（a）-0071-03

Analysis of Clinical conditions of elderly patients of the first receiving hemodialysis in single center

ZENG Yu-ran TAN Feng-jiao YAN Li-jun LIN Wan-min

Department of Hematology，the First Affiliated Hospital of Medical College of Shantou University，Guangdong Province，Shantou 515041，China

[Abstract]Objective To analyze the clinical conditions of elderly patients who first underwent hemodialysis so as to reflect their characteristics.Methods The primary causes，complications and laboratory findings of 185 newly-diagnosed patients who first underwent hemodialysis in our hospital from January 2013 to December 2015 were analyzed.Results Among 185 cases of elderly patients who first underwent hemodialysis，the diabetic nephropathy （54.6%），chronic glomerulonephritis （21.1%） and hypertensive nephropathy （14.6%） ranked the top three primary causes.Severe complications included acute left heart failure，severe acidosis，hyperkalemia，severe anemia，and the incidence rate was 34.6%，35.7%，19.5% and 20.0%，respectively.Two or more serious complications occurred in more than 30% of the elderly patients with initial hemodialysis.Conclusion The primary etiology of elderly patients who accepted initial hemodialysis includes diabetic nephropathy，chronic glomerulonephritis and renal hypertension.And the patients with hemodialysis often are associated with high incidence of serious complications.

[Key words]Elderly；Hemodialysis；Primary causes；Complication

随着生活环境的改善以及医疗技术的进步，人均寿命日益延长，而慢性肾脏病的患病率也随着年龄的增长而增加，以至接受血液透析的老年终末期肾脏病患者增加明显。2009年美国老年透析患者已占总透析患者的65%，2013年的肾脏病数据系统数据显示终末期肾脏病患者起始血液透析的平均年龄已达62.1岁，较20年前的起始透析年龄明显增加[1-2]。老年人的肾脏由于结构改变、功能减退，对各种应激因素的抵抗能力下降，同时老年终末期肾脏病患者的另一特征是常患有多种基础疾病，这导致其进入血液透析时并发症发生率及死亡率均较高。本研究对我院近年来新增的老年初次血液透析患者的情况进行分析，反映老年初次血液透析患者的特点，为针对性干预治疗提供依据，现报道如下。……