ABSTRACT
Objective:To evaluate the risk factors of hypoalbuminemia (serum albumin <35 g/L) in the maintenance hemodialysis (MHD) patients.Methods:From January 2011 to December 2018, 915 patients (≥18 years) who underwent MHD programs from 12 hospitals in south China were enrolled in a retrospective analysis. Univariate and multivariate Logistic regression analysis was applied to evaluate the risk factors of hypoalbuminemia in the MHD patients.Results:The MHD patients had poor albumin level in general, with hypoalbuminemia accounting for about 20.55% (188/915). Compared with the patients with normal albumin level, the patients with hypoalbuminemia had older age (61.46 years vs. 55.85 years, P<0.01), the greater incidence of diabetes [29.79%(56/188) vs. 19.39%(141/727), P = 0.002] and the lower application in high flux dialysis [42.55%(80/188) vs. 57.36%(417/727), P<0.01], while the gender, duration of dialysis, dialysis frequencies and the incidence of hepatitis showed no significant difference between 2 groups. In linear correlation analysis, albumin and hemoglobin level were positively correlated ( r = 0.213, P<0.01). In Spearmen correlation analysis, albumin was negatively correlated with age, hypersensitive C reactive protein (hsCRP), alkaline phosphatase, and diabetes ( r = -0.232, -0.176, -0.153 and -0.132; P<0.01); and it was positively correlated with the Kt/V and the application in high flux dialysis ( r = 0.151 and 0.124, P<0.01). The multivariate Logistic regression analysis showed that age, diabetes, alkaline phosphatase and hsCRP were the independent risk factors of hypoalbuminemia, while the application of high flux dialysis and hemoglobin were the independent protection factors. Conclusions:The patients undergoing a MHD program have poor albumin level. Diabetes is the independent risk factor of hypoalbuminemia of MHD patients, and the practice of high flux dialysis may reduce the hypoalbuminemia.
ABSTRACT
Objective To study the clinical efficacy and safety of purse-string suture on the treatment of peptic ulcer bleeding. Methods Data of 42 patients with peptic ulcer bleeding treated by purse-string suture with hexiejia combined with endoloop in Dongguan Tung Wah Hospital from January 2016 to January 2017 were retrospectively analyzed. The immediate hemostasis rate, effective hemostasis rate, additional surgery rate, recurrence rate in two weeks and mortality were analyzed. Results Among 20 cases with active bleeding during operation, 19 were immediately arrested, and 1 case of failure was diagnosed as marginal ulcer after gastric resection. The overall effective hemostasis rate was 97. 6%(41/42), additional surgery rate was only 2. 4%( 1/42). The vital signs of 41 patients with successful endoscopic hemostasis were stable after operation, and no fever, hematemesis, black stool or other symptoms occurred. No recurrence of bleeding or death occurred within two weeks. The ulcers were healed well in follow-up of one month. Conclusion Endoscopic purse-string suture is a safe and feasible method for treatment of patients with peptic ulcer bleeding.