血液透析通路使用现状及更换次数影响因素分析

Analysis of Vascular Access and Relevant Factors Among Maintenance Hemodialytic Patients

目的了解维持性血液透析患者的通路应用现状,探讨影响通路更换的因素。方法统计2010年1月1日～2011年6月30日期间笔者区院124例维持性血液透析患者的临床资料、通路更换次数,分析影响更换次数的因素。结果 124例患者透析开始年龄25～87岁不等,平均年龄63.6±16.1岁;透析病程2～120个月不等,平均病程27.4±30.3个月;更换次数共159次,平均1.3次;使用通路279条,长期通路162条,以自体内瘘最多(66.7%)。24个月内新建的长期通路中,中心静脉置管比例有增加的趋势。统计分析显示,患者透析龄与更换次数相关,透析龄超过24个月的患者更换次数>1的机会明显增加(P<0.05)。结论自体动静脉内瘘一直是使用最多的长期透析通路,但近期使用中心静脉置管有上升趋势;透析龄是影响透析通路更换次数的重要因素。

Objective To study vascular access condition and factors affecting access in maintenance hemodialytic patients. Meth- ods A total of 124 patients were included in the study from January 1,2010 to June 30,2011. Such clinical characteristics as age, gen- der, year of hemodialysis, etiology of renal failure, type and time of vascular access, and numbers of change in access, were collected and analyzed. Results Diabetes was the primary diease of renal failure, followed by hypertention and glomerulonephritis. Of 124 patients a- vailable for analysis, 30 patients changed their accesses more than one times. Year of hemodialys was an independent factor affecting the numers of access in patients（ P 〈 0.05 ）. There were 279 accesses in all and 2.3 on average. Of 162 permantent accesses, arterivenous fis- tula accounted for 66.7% and catheter 32.7%. The number of patients undergoing chronical dialysis with a catheter increased wintin 24 monthes. Conclusion Arterivenous fistula is the most common access in patients on long - term bemodialysis. However, the porprotion of central venous catheters had been increasing. Year of hemodialysis is an important role affecting the number of vascular access in a patient.