维持性血液透析患者不同血管通路比较

Comparison of Different Vascular Access in Patients Receiving Chronic Hemodialysis

目的比较自体动脉-静脉内瘘(AV内瘘)、半永久插管和聚四氟乙烯(PTFE)人工移植血管透析血流量、尿素清除指数(Kt/V)、血栓、感染的差异。方法将入选的58例血液透析患者分成3组:AV内瘘组(30例)、半永久插管组(18例)、PTFE人工血管组(10例),比较3组患者的透析血流量、Kt/V以及感染、血栓形成的发生率。结果 3组患者的透析血流量、Kt/V间差异均无统计学意义(P>0.05)。半永久插管组的血栓形成、感染的发生率均明显高于AV内瘘组和PTFE人工血管组,差异有统计学意义(P<0.05),而AV内瘘组和PTFE人工血管组的血栓形成、感染的发生率比较,差异无统计学意义(P>0.05)。结论 AV内瘘为血液透析的首选血管通路;PTFE人工血管较半永久插管有更低的感染和血栓形成发生率。

Objective To investigate the difference between AVF,semi permanent catheter and PTFE and blood flow of artificially transplanted blood vessels,Kt/V,thrombi and infection.Methods 58 patients receiving chronic hemodialysis were divided into three groups,with 30 cases in AVF group,18 cases in semi permanent catheter group and 10 cases in PTFE AVGs group.Compare the difference between blood flow,Kt/V and incidence of infection and thrombi.Results The difference is not significant between the 3 groups in blood flow and Kt/V（P0.05）.Incidence of thrombi and infection is significantly higher than that of AVF group and PTFE AVGs group （P0.05）,but the different incidence of thrombi and infection between AVF group and PTFE AVGs group is not significant （P0.05）.Conclusion The AVF should be the first choice for vascular access among patients receiving chronic hemodialysis.The PTFE AVGs were superior to semi permanent catheter in infection and thrombi.