老年血液透析血管通路的建立

Establishment of blood access in elderly hemodialysis patients

随着社会老龄化的进程、医疗保险制度的发展和透析技术的进步,老年血液透析患者越来越多。因为老年患者外周血管条件差、合并多种基础疾病、心脏功能减退等因素,导致其透析用血管通路的建立一直是困扰临床的一大难题。该文作者认为在为老年患者建立血管通路的过程中,应该本着以自体动静脉内瘘为首选的原则,同时根据具体患者的预期寿命、血管条件以及患者的意愿作为重要参考因素,最终为老年患者建立既能够满足透析需要,又能最终提高患者生存质量的透析用血管通路。

There will be more and more elderly patients surviving on hemodialysis due to improvement of renal replacement and medical insurance. But these patients might experience lots of dilemmas such as poor blood vessels,more complications,and impaired cardiac function. All of these factors impose restriction on blood access preparation. Based on our previous reports,in most elderly subjects autogenous arteriovenous fistula might be the first choice in consideration of expectation of life,blood vessels available,life styles and ideas of the patients,which would accordingly assure effective renal replacement and high quality of life.