维持性血液透析合并结核患者的临床分析
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摘要
目的对维持性血液透析合并结核患者的临床特点进行研究与分析。方法选取2015年1月至2016年1月于本院接受治疗的维持性血液透析患者228例,采用回顾性分析的方法探究维持性血液透析患者并发结核的发病部位、发病症状以及发病率,同时也探究患者血红蛋白、血浆白蛋白以及KT/V等方面的指导,分析患者的转归与治疗。结果参与本次实验研究的228例研究样本中包含9例合并结核感染患者,症状表现主要为咳痰、咳嗽、发热、纳差、乏力以及消瘦等。发病部位包含肺结核与肺外结核两种。患者血红蛋白、血浆白蛋白以及KT/V等方面的指导均有所下降。为全部患者提供抗结核治疗共取得了88.9%的治疗总有效率。结论维持性血液透析很有可能会出现结核症状,同时也可能引发透析充分性下降、贫血加重以及营养不良等方面的问题,需要为患者提供持续的观察,一旦发现患者出现结核感染的先兆,一定要尽早重视、尽早治疗。
Objective To study and analyze the clinical characteristics of maintenance hemodialysis patients with tuberculosis. Methods 228 patients with maintenance hemodialysis who were treated in our hospital from January 2015 to January 2016 were selected. The location, symptoms and incidence of tuberculosis in maintenance hemodialysis patients were retrospectively analyzed. At the same time, the guidance of hemoglobin,plasma albumin and KT/V was explored, and the prognosis and treatment of patients were analyzed. Results The 228 study samples included 9 patients with tuberculosis infection. The main symptoms were expectoration, cough, fever, poor appetite, fatigue and emaciation. The site of onset includes tuberculosis and extrapulmonary tuberculosis. The guidance of hemoglobin, plasma albumin and KT/V decreased. The total effective rate of anti-tuberculosis treatment was 88.9% for all patients. Conclusion Maintenance hemodialysis is likely to cause tuberculosis symptoms, but also may cause dialysis adequacy decline, anemia aggravation, malnutrition and other problems. It is necessary to provide continuous observation for patients.Once the symptoms of tuberculosis infection are found, we must pay attention to them as soon as possible and treat them as possible.
Objective To study and analyze the clinical characteristics of maintenance hemodialysis patients with tuberculosis. Methods 228 patients with maintenance hemodialysis who were treated in our hospital from January 2015 to January 2016 were selected. The location, symptoms and incidence of tuberculosis in maintenance hemodialysis patients were retrospectively analyzed. At the same time, the guidance of hemoglobin,plasma albumin and KT/V was explored, and the prognosis and treatment of patients were analyzed. Results The 228 study samples included 9 patients with tuberculosis infection. The main symptoms were expectoration, cough, fever, poor appetite, fatigue and emaciation. The site of onset includes tuberculosis and extrapulmonary tuberculosis. The guidance of hemoglobin, plasma albumin and KT/V decreased. The total effective rate of anti-tuberculosis treatment was 88.9% for all patients. Conclusion Maintenance hemodialysis is likely to cause tuberculosis symptoms, but also may cause dialysis adequacy decline, anemia aggravation, malnutrition and other problems. It is necessary to provide continuous observation for patients.Once the symptoms of tuberculosis infection are found, we must pay attention to them as soon as possible and treat them as possible.
引文
[1]中国医院协会血液净化中心管理分会专家组.中国成人慢性肾病合并结核病管理专家共识[J].中国血液净化,2016,11(6):577-586.
[2]陶娟,李涛,陈永华,等.维持性血液透析患者感染的相关因素临床分析[J].当代医学,2012,18(12):77-78.
[3]刘苏来,安瑞华,刘瑛,等.维持性血液透析合并尿路上皮癌患者临床特点及危险因素分析(附11例报告)[J].临床泌尿外科杂志,2012,27(10):750-752,755.
[4]于玲,李寒,王世相,等.维持性血液透析患者合并退缩人综合征5例临床分析[J].中国血液净化,2011,10(5):239-241,261.
[5]郑海兰.95例尿毒症维持性血液透析患者并发症的临床分析[J].医学信息,2011,24(8):3960-3961.
[6]郭彦聪,徐艳春,王小月.维持性血液透析患者并发结核9例回顾性分析[J].中国血液净化,2005,4(9):484-486.
[7]叶红,曹红娣,吴文慧,等.维持性血液透析合并恶性肿瘤患者的临床特征分析[J].中国中西医结合肾病杂志,2014,4:336-337.
[8]张秀安.维持性血液透析患者合并急性脑出血12例的临床分析[J].中国社区医师,2015,31(36):32,35.
[9]张微.224例维持性血液透析患者并发胸腔积液的临床分析[J].吉林医学,2013,34(7):1323-1324.
[10]赵媛媛,夏瑗瑜,喻业安,等.终末期糖尿病肾病维持性血液透析患者并发结核感染11例临床分析[J].中国医学创新,2012,9(11):123-124.
[2]陶娟,李涛,陈永华,等.维持性血液透析患者感染的相关因素临床分析[J].当代医学,2012,18(12):77-78.
[3]刘苏来,安瑞华,刘瑛,等.维持性血液透析合并尿路上皮癌患者临床特点及危险因素分析(附11例报告)[J].临床泌尿外科杂志,2012,27(10):750-752,755.
[4]于玲,李寒,王世相,等.维持性血液透析患者合并退缩人综合征5例临床分析[J].中国血液净化,2011,10(5):239-241,261.
[5]郑海兰.95例尿毒症维持性血液透析患者并发症的临床分析[J].医学信息,2011,24(8):3960-3961.
[6]郭彦聪,徐艳春,王小月.维持性血液透析患者并发结核9例回顾性分析[J].中国血液净化,2005,4(9):484-486.
[7]叶红,曹红娣,吴文慧,等.维持性血液透析合并恶性肿瘤患者的临床特征分析[J].中国中西医结合肾病杂志,2014,4:336-337.
[8]张秀安.维持性血液透析患者合并急性脑出血12例的临床分析[J].中国社区医师,2015,31(36):32,35.
[9]张微.224例维持性血液透析患者并发胸腔积液的临床分析[J].吉林医学,2013,34(7):1323-1324.
[10]赵媛媛,夏瑗瑜,喻业安,等.终末期糖尿病肾病维持性血液透析患者并发结核感染11例临床分析[J].中国医学创新,2012,9(11):123-124.