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目的:探讨如何提高糖尿病肾病患者的透析水平,以进一步改善其生活质量和提高存活率。方法:对糖尿病肾病透析患者20例和非糖尿病肾病透析患者43例,比较2组患者首次透析前的尿素氮、肌酐、透析期间发生的并发症,死亡原因、存活情况。结果:糖尿病肾病患者存活3年组与3年内死亡组首次透析前肌酐、尿素氮,死亡组指标水平明显高于存活组(p<0.05)。糖尿病肾病组透析低血压、感染发生率、心功能不全等均明显高于非糖尿病肾病组。3年和5年的存活率糖尿病肾病组明显低于非糖尿病肾病组(p<0.05)。结论:通过对糖尿病肾病患者透析时机的较好选择、并发症的防治,胰岛素的合理用药可以改善患者的生活质量和提高存活率。
OBJECTIVE: To explore ways to improve dialysis in patients with diabetic nephropathy to further improve their quality of life and improve survival. Methods: 20 patients with diabetic nephropathy and 43 patients with non-diabetic nephropathy were enrolled in this study. Pre-dialysis urea nitrogen and creatinine were compared between the two groups. Complications, causes of death and survival during dialysis were compared. Results: The indexes of creatinine, urea nitrogen and death in the patients with diabetic nephropathy survived 3 years and died within 3 years were significantly higher than those in survivors before the first dialysis (p <0.05). Diabetic nephropathy dialysis hypotension, the incidence of infection, cardiac insufficiency were significantly higher than non-diabetic nephropathy group. The 3-year and 5-year survival rates in diabetic nephropathy group were significantly lower than those in non-diabetic nephropathy group (p <0.05). Conclusion: Through the better choice of timing of dialysis in patients with diabetic nephropathy, the prevention and treatment of complications, the rational use of insulin can improve the quality of life of patients and improve the survival rate.