Résumé
Objective To investigate the death causes and risk factors of uremia patients in order to improve the prognosis of uremia patients.Methods Clinical data of 247 uremia inpatients and outpatients from 2001 to 2011 in our hospital were retrospectively analyzed.Dead patients were served as death group (n=124) and survival patients as control group (n=123).Death causes and primary disease were studied.Frequency of hemodialysis,prealbumin,albumin,natremia and pulmonary infection were compared between two groups.Results Age and gender were not associated with the death of uremia patients.The most common cause of death was cardiovascular disease followed by respiratory failure,uremic encephalopathy,cerebral hemorrhage,gastrointestinal hemorrhage,etc.Hemodialysis frequency,prealbumin,albumin and natremia of dead patients were obviously lower than those of control group.More patients in death group suffered from pulmonary infection.Logistic multivariate analysis revealed that death risk increased by 40.7％ when reducing 1 time per week of hemodialysis; death risk increased by 53.4％ when reducing 50 mg/L of prealbumin; death risk increased by 14.6％ when reducing 5 mmol/L of blood sodium; death risk of patients with pulmonary infection increased by 15.06 times of patients without pulmonary infection;death risk of diabetes mellitus increased by 4.26 times of patients without diabetes mellitus.Conclusions Cardiovascular disease,respiratory failure,uremic encephalopathy,cerebral hemorrhage,and gastrointestinal hemorrhage are common causes of death in uremia patients.Hemodialysis frequency,prealbumin,hyponatremia,pulmonary infection and diabetes can be regarded as risk factors for death of uremia patients.
Résumé
Objective To observe the feasibility of laryngeal mask ventilation general anesthesia com- bined epidural block in laparoseopie eholecystectomy. Methods One hundred and forty eases of selective laparoscopie eholecystectomy were performed to T8～T9 gap catheterization, with 1.5 percent lidoeaine epi- dural block, block levels in the following T4. After conventional anesthesia into 4# or 5# LMA, balloon gas was injected in 20 mL～30 mL, manual ventilation, respiratory resistance and the situation thorax ups and downs were observed. Results The patients epidural catheterization smoothly, in the anesthesia plane fol- lowing T4, insert the LMA blood pressure, heart rate without significant change. Pneumoperitoneum after the rebound in blood pressure[(20.6 5.0) mm Hg], heart rate did not change significantly, and then airway pressure increased[(5.7 1.6)cm H2O] , surgery performed smoothly, and quickly regained consciousness after the surgery, when all patients admitted gallbladder, they have resumed breathing independently. Con- dusion Laryngeal Mask Airway general anesthesia combined epidural block cause mechanical damage vocal cords and airway, make the stress response light and the sense of rapid recovery, which is a safe and feasible method of anesthesia.