关键词: 血液透析, 生存率, 死亡原因, 影响因素

Abstract: Objective To analyze the long-term survival of patients with single-center maintenance hemodialysis (MHD), and to guide clinical practice to improve survival rat. Methods A retrospective study was carried out in 132 MHD patients in. Of the 132patients,54 dead were designated as the experimental group and the other 78 survivals as the control. Cox regression proportional hazard model were used to investigate the effects of clinical indicators on the prognosis of patients. The data of laboratory examination and dialysis indexes, and to count the 10-year survival rate and the risk factors of the survival rate of MHD patients. Results Over all the 10-year survival rate was 33%. Kaplan-Meier analysis showed patient survival as 90% at one-year, 86% at 3-years,82% at 5-years, and33% at 10-years. Cox regression proportional hazard model showed that Internal fistula (or = 0.025,95% CI: 0.095~0.654, P & Lt; 0.001) , age > 60 years (or = 3.17,95% CI: 1.451~6.925, P = 0.004) , cardiovascular disease (OR = 2.01,95% CI: 0.984~4.097, p = 0.055) , Kt/V > 1.2(or = 0.298,95% CI: 0.113~0.690, P = 0.006)were associated with survival. The internal fistula and KT/V ≥1.2 were protective factors, and the age over 60 years with cardiovascular disease and cerebrovascular disease were risk factors.Cardiovascular and cerebrovascular diseases, infection is the main cause of death. Conclusion Cardio- cerebro- vascular diseases,and infection are the main causes of death in maintenance hemodialysis patients. The survival rate can be improved by changing the access of dialysis to internal fistula in time.

Key words: hemodialysis, survival rate, cause of death, risk factors