透析患者并发恶性肿瘤的临床分析

Clinical analysis of malignant tumor in dialysis patients

关键词:  尿毒症  透析  恶性肿瘤

Key words:  uraemia  dialysis  malignant tumor

摘要:

［目的］分析尿毒症患者在透析期间恶性肿瘤的发病状况及其预后。［方法］横断面调查541例透析患者在透析治疗期间发生恶性肿瘤的情况。［结果］541例透析患者中，透析后并发恶性肿瘤18例，发生率为3.3%。血液透析(HD)组发生率为5.7%（17/297例），腹膜透析（PD）组发生率为0.4%（1/244例），HD组明显高于PD组，P<0.005。泌尿、消化及呼吸系统肿瘤最常见。肿瘤患者平均年龄（65.5±10.4）岁,明显高于非肿瘤患者平均年龄（58.0±14.1）岁，P<0.05。并发肿瘤患者的死亡率为77.8%（14/18例），死亡原因为肿瘤12例和心血管疾病2例。生存的4例患者均接受过手术、化疗或中药治疗。［结论］尿毒症透析患者恶性肿瘤的发生率较高，且预后差。对透龄较长的老年患者更应重视肿瘤筛查。

Abstract:

［Objective］To analysis the incidence of malignant tumor in the uraemia patients with dialysis and their prognosis.［Methods］There were 541 dialysis patients studied by cross section,to investigate the incidence of malignant tumor and the clinical features of the malignant tumor.［Results］Among the 541 dialysis patients,18 cases with malignant tumor were found.The morbidity of malignant tumor was 3.3%(18/541).17 cases were found in 297 patients of hemodialysis (HD) with the incidence of 5.7%,one case was found in 244 patients of peritoneal dialysis (PD) with the incidence of 0.4%.HD group was more greater than PD group,P<0.005.Tumors of urinary,digestive and respiratory system were most frequent.As compared with non-tumour patients,the mean age of the tumour patients was greater (65.5±10.4)years vs (58.0±14.1)years,P<0.05.The mortality of malignant tumor in dialysis patients was 77.8% (14/18 ).The causes of death were malignant tumor (12 cases)and cardiovascular diseaes(2 cases).4 cases of survival had been accepted operation equally or the chemotherapy or traditional Chinese medicine.［Conclusion］The incidence of malignant tumor the uraemia patients with dialysis was markedly higher and poor prognosis.checking the tumour should be seriously more for the patients of old age and longer time of dialysis.