血透患者内瘘闭塞的临床分析

Clinical Analysis on Status of Arterioveneous Fistula Occlusion in Hemodialysis Patients

目的分析血液透析患者动静脉内瘘(内瘘)闭塞情况及其影响因素。方法随访调查2004年1月至2009年12月期间242例长期HD患者的内瘘闭塞情况。结果 242例患者中有32例,共发生42次内瘘闭塞,内瘘闭塞率为17.4%。内瘘闭塞组的内瘘使用时间为(17.9±19.6)个月(0.5～74个月),因内瘘闭塞无法血透而导致死亡有4例,死亡率为1.7%。与非糖尿病组比较,糖尿病组内瘘使用时间明显减少(25.9±20.8)个月和(4.8±5.4)个月,t=2.796,P<0.01)。与慢性肾小球肾炎组比较,糖尿病组内瘘闭塞发生率明显增高(11.5%和17.6%,X2=4.370,P<0.05)。结论糖尿病、血管条件差、低血压、内瘘提早使用及内瘘压迫时间久是导致内瘘闭塞的主要原因。

Objective Toanalyze the status of arterioveneous fistula occlusionin in hemodialysis patients and its impact factor.Methods The status of arterioveneous fistula occlusion in 242 patients with HD was observed in the period from January,2004 to December,2009.Results Among 242 patients 32 people occured fistula occlusion for 42 times,fistula occlusion rate was 17.4%.Usage time of fistula was（17.9±19.6）months（0.5-74 months）in fistula occlusion group.4 cases were dead due to fistula occlusion that couldn＇t hemodialyze,the mortality rate was 1.7%.As compared with the non-diabetes group,the usage time of fistula in the diabetes group was significantly reduced （25.9±20.8）months v.s.（4.8±5.4）months,t=2.796,P〉0.01）.As compared with the chronic glomerulonephritis group,the incidence rate of the fistula occlusion in the diabetes group was significantly increased（11.5%v.s.17.6%, X^2=4.370,P〉0.05）.Conclusion The major factors of arterioveneous fistula occlusion are diabetes,poor vascular condition,low blood pressure,early use of fistula and log-time fistula compression.