Clinical analysis of 28 patients with gastrointestinal bleeding in maintenance hemodialysis / 中国基层医药

ABSTRACT

Objective To explore the reasons and clinical characteristics of gastrointestinal bleeding in maintenance hemodialysis patients.Methods Clinical data of 28 hemodialysis patients combined with gastrointestinal bleeding were retrospectively analyzed.The reasons and clinical characteristics of gastrointestinal bleeding were analyzed.Results The incidence rate of gastrointestinal bleeding in hemodialysis patients was 20.9%,hemorrhage of upper digestive tract in 23 cases (82.1%)and hemorrhage of lower digestive tract in 5 cases (17.9%).The reasons of hemorrhage of upper digestive tract were mucosal erosion bleeding of gastric esophagus duodenum in 15 cases (65.2%)and peptic ulcer in 8 cases (34.8%).The positive rate of helicobacter pylori infection was 66.7%(12 /18).In 10 cases (35.7%),gastrointestinal bleeding happened within three months after hemodialysis.Vascular access for hemodialysis were used by central venous catheterization in 13 cases (46.4%)and arteriovenous fistula in 15 cases (53.6%).The prognosis of gastrointestinal bleeding in hemodialysis patients were continuing hemodialysis in 23 cases (82.1%),turned to peritoneal dialysis in 2 cases (7.2%)and death in 3 cases (10.7%).Conclusion The major reason of gastrointestinal bleeding in hemodialysis patients is hemorrhage of upper digestive tract.Mucosal erosion bleeding of gastric esophagus duodenum is major in hemorrhage of upper digestive tract.The positive rate of helicobacter pylori infection is higher.More than 1 /3 gastrointestinal bleeding happens within three months after hemodialysis.The prognosis of the majority of patients is good by internal medicine combined therapies and no heparin hemodialysis.