Chandran P K, Lane T, Flynn C T
Nephrology Clinic, University of Iowa College of Medicine, Des Moines.
Int J Artif Organs. 1991 May;14(5):262-8.
A retrospective analysis of patient and technique survival over 10 years in a group of 66 diabetics (40 being blind) and 71 non-diabetics was undertaken. Patient survival profiles showed that the blind diabetics lived longer than the sighted, but for a shorter time than the nondiabetics. In technique success, the sighted diabetics out did the blind and the non-diabetics, long term. Short term, the blind performed better than sighted diabetics. The key to success and longer survival on CAPD depended on motivation on the part of the patient, patient's acceptance of given disability, family (social) support, and willingness on the part of renal care personnel to train the disabled diabetic to perform CAPD. With adequate education and support, blind diabetics did CAPD as well as sighted patients. There was no increased frequency of peritonitis in blind diabetics compared to sighted diabetics. Both blind diabetics and non-diabetics had fewer episodes than sighted diabetics. Intraperitoneal route of insulin administration achieved good glycemic control in diabetic population. Refractory congestive cardiac failure and/or fatal arrhythmias was the most common cardiac cause of death in diabetics on CAPD.
对一组66名糖尿病患者(40名失明)和71名非糖尿病患者进行了为期10年的患者及技术生存情况的回顾性分析。患者生存情况表明,失明的糖尿病患者比有视力的糖尿病患者寿命更长,但比非糖尿病患者的寿命短。在技术成功率方面,从长期来看,有视力的糖尿病患者优于失明患者和非糖尿病患者。短期来看,失明患者的表现优于有视力的糖尿病患者。持续性非卧床腹膜透析(CAPD)成功及长期生存的关键取决于患者自身的积极性、患者对自身残疾状况的接受程度、家庭(社会)支持以及肾脏护理人员培训残疾糖尿病患者进行CAPD的意愿。通过充分的教育和支持,失明糖尿病患者进行CAPD的效果与有视力的患者相当。与有视力的糖尿病患者相比,失明糖尿病患者腹膜炎的发生率并未增加。失明糖尿病患者和非糖尿病患者的腹膜炎发作次数均少于有视力的糖尿病患者。腹腔内注射胰岛素在糖尿病患者群体中实现了良好的血糖控制。难治性充血性心力衰竭和/或致命性心律失常是接受CAPD治疗的糖尿病患者最常见的心脏死因。