天津医药

天津医药 ›› 2023, Vol. 51 ›› Issue (5): 527-529.doi: 10.11958/20221457

• 临床研究 • 上一篇    下一篇

2019—2020年北京地区血液透析患者院前急救现状分析

张寅1(), 周亦伦1, 孟德志2, 黄琪1, 张进军3,△()   

  1. 1.首都医科大学附属北京天坛医院肾内科（邮编100070）
    2.北京丰台医院重症医学科
    3.北京急救中心
  • 收稿日期:2022-09-13 修回日期:2022-12-13 出版日期:2023-05-15 发布日期:2023-05-05
  • 通讯作者: △E-mail:zhang92560@163.com
  • 作者简介:张寅（1986），女，主治医师，主要从事肾脏疾病及血液净化方面研究。E-mail：zhangyin1228@163.com

Analysis of pre-hospital emergency use for maintenance hemodialysis patients in 2019—2020 Beijing area

ZHANG Yin1(), ZHOU Yilun1, MENG Dezhi2, HUANG Qi1, ZHANG Jinjun3,△()   

  1. 1. Department of Nephrology, Beijing Tiantan Hospital, Capital Medical University, Beijing100070, China
    2. Department of Intensive Care Unit, Beijing Fengtai Hospital
    3. Beijing Emergency Medical Center
  • Received:2022-09-13 Revised:2022-12-13 Published:2023-05-15 Online:2023-05-05
  • Contact: △E-mail:zhang92560@163.com

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摘要：

目的 探讨北京地区维持性血液透析（MHD）患者院前急救呼叫的主要原因以及MHD患者院前急救呼叫在1周内随透析时间的分布规律。方法 回顾性分析北京急救中心2019年7月—2020年6月受理出诊的572例MHD患者院前急救呼叫情况。男349例（61.0%），女223例（39.0%），平均年龄（67.1±13.0）岁，中位透析龄为5（2，9）年。收集患者临床信息、呼叫院前急救原因及其在1周内分布情况及与患者透析时间的关系。结果 572例MHD患者院前呼叫急救的最常见原因是心力衰竭（89例，15.6%），其次为猝死（77例，13.5%），第三为脑血管病（58例，10.1%）。MHD患者院前急救呼叫发生率和猝死发生率在长透析间隔后第1个透析日（周一、周二）最高。心力衰竭导致的院前急救呼叫多发生在长透析间隔末期，即周日和周一。脑血管病风险与透析时间无明确变化规律。结论 心力衰竭、猝死和脑血管病是MHD患者急救的主要原因。长透析间隔可能导致MHD院前急救风险增加。

关键词: 维持性血液透析, 院前急救, 长透析间隔

Abstract:

Objective To investigate the main cause of pre-hospital ambulance use and its day-of-week pattern of distribution according to hemodialysis schedule in a cohort of maintenance hemodialysis (MHD) patients in Beijing. Methods A cohort of 572 MHD patients that called pre-hospital ambulance in Beijing between July 2019 and June 2020 were retrospectively analyzed. There were 349 males (61.0%) and 223 females (39.0%), the mean age was (67.1±13.0) years, and the median dialysis age was 5 (2,9) years. Patient characteristics, main cause of pre-hospital ambulance calls and day-of-week distribution patterns of pre-hospital ambulance calls were collected. Results The most common reason for pre-hospital emergency calls in 572 patients with MHD was heart failure (89 cases, 15.6%), followed by sudden death (77 cases, 13.5%) and cerebrovascular disease (58 cases, 10.1%). The highest incidence of prehospital ambulance utilization and sudden death in MHD patients occurred on the days following the longest dialysis interval (Mondays and Tuesdays). Pre-hospital emergency calls for heart failure occurred more often at the end of the longest dialysis intervals, on Sundays and Mondays. The risk of cerebrovascular disease had no association with dialysis schedules. Conclusion Heart failure, sudden death and cerebrovascular disease are the main causes of pre-hospital ambulance calls in MHD patients. Long dialysis intervals may lead to an increased risk of pre-hospital ambulance use in MHD patients.

Key words: maintenance hemodialysis, pre hospital first aid, long dialysis interval

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