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1、尿毒症长期血液透析患者伴发病诊治分析作者：徐丽娟，李照辉，卢小昭，罗会文，于桂芹【摘要】目的探讨尿毒症长期血液透析患者伴发病的诊断和治疗。方法2001～2008年在我院透析的181例患者，男106例，女75例，年龄17～86岁，平均54.9岁，透析时间6个月～13年，平均2.4年。结果28例患者合并与尿毒症和透析无关的伴发病，其中胆结石6例，肿瘤5例，糖尿病2例，食管黏膜脱落征2例，青光眼3例，白内障7例，急性阑尾炎1例，铁粒幼细胞性贫血1例，原发性血小板减少性紫癜1例。其中肿瘤4例死亡，手术治疗1例，胆结石手术3例，急性阑尾炎手术
2、1例，白内障换晶体3例，青光眼手术1例，术后均恢复良好，其余患者经对症治疗病情稳定。结论尿毒症患者与正常人或其他患者一样，除尿毒症和长期血透并发症外仍会患其他疾病；正确评估患者全身状况，保持内环境稳定，这类患者仍然可以接受创伤性和非创伤性的检查和治疗。【关键词】尿毒症；血液透析；诊治［Abstract］ObjectiveToinvestigatethediagnosisandtherapyofuremiapatientswhoreceivedlongtermhemodialysis.Methods181casesofuremiapa
3、tientswhoreceivedhemodialysisinourhospitalfrom2001to2008wereanalyzedretrospectively.Therewere106maleand75femalewithanaverageageof54.9（17～86）years.Theperiodofhemodialysisforthepatientsarrangedfrom0.5to13yearsandwasontheaverage2.4years.Results28patientshadconcomitantdise
4、aseswhichwerenorelationshipwithuremiaandhemodialysis,including6caseswithgallstone,5caseswithtumor,2caseswithdiabete,2caseswithexfoliativeesophagitis,3caseswithglaucoma,7caseswithcataract,1casewithacuteappendicitis,1casewithsideroblasticanemiaand1casewithidiopathicthrom
5、bocytopenicpurpura.Of28patients,4patientswithtumordied,1withtumorreceivedoperation,3withgallstonereceivedoperations,1withacuteappendicitisreceivedtheoperation,3withcataractwerereplacedlens,1withglaucomareceivedtheoperation.Alltheirrecoveryofpostoperationwerewell.Afterr
6、eceivingsymptomatictreatments,otherpatientshadstablesituations.ConclusionBesidesuremiaandlongtermhemodialysiscomplications,uremiapatientsstillcouldhaveotherdiseases,whichwerethesameasnormalpeopleorotherpatients.Ifproperlyevaluatethepatients’wholesituationandkeeptheirho
7、meostasis,thepatientscouldstandthetraumaticornontraumaticexaminationsandtherapy.［Keywords］uremia;hemodialysis;concomitantdiseases4尿毒症长期血透患者有尿毒症并发症和长期血液透析并发症，也可合并与上述两项无关的伴发病。前两项并发症报道较多，临床医生给予了较多关注，而尿毒症透析患者伴发病的诊断和治疗报道较少，笔者对这部分患者进行报道以便临床医生开拓思路，及时诊断和治疗，提高患者生活质量。1临床资料 我院20
8、01～2008年长期门诊血透患者181例，男106例，女75例，年龄17～86岁，平均54.9岁。原发病为慢性肾小球肾炎133例，糖尿病肾病26例，高血压肾病15例，多囊肾4例，狼疮肾2例，血管炎1例。透析前尿素氮23～45mmol/
