维持性血液透析血管通路现状及影响因素分析

Investigation of vascular access in maintenance hemodialysis and influence factors

回顾性分析维持性血液透析(MHD)患者的基本资料、首次血液透析(HD)不同血管通路(VA)的选择及动静脉内瘘(AVF)患者并发症发生率情况。对比分析首次HD时使用AVF与临时静脉置管(TCVC)患者的文化教育程度、经济状况及AVF使用寿命情况。首次HD使用TCVC占72.9%,AVF占25.7%。自体AVF是本透析中心MHD患者最主要的VA(96.2%),但首次HD采用自体AVF的比例(25.7%)仍低于指南要求。提前建立AVF与其所受文化教育水平、经济状况呈正相关性,差异有统计学意义(P<0.05),有利于减少患者AVF远期并发症的发生;而与患者的性别、年龄、原发疾病及后期内瘘血流量情况差异无统计学意义。

210 MHD patients were retrospectively analyzed for the basic information in the hemodialysis（ HD） cen-ter, including the vascular access（ VA） options and the incidence of complications with AVF. The patients were as-signed into two groups, i. e. the AVF and the temporary central venous catheter（ TCVC） , and the information of ed-ucation, economic status and AVF life were compared. The most popular VA at the beginning of HD was TCVC （72. 9%）, then AVF（25. 7%）. AVF was the main VA of MHD patients （96. 2%）, but the proportion of the first HD with AVF （25. 7%） was still lower than the proportion of the guide. The patients with preparation of AVF in advance were positively correlated with their cultural education level and economic status, which had fewer long-term complications than others. There was a statistically significant difference （P〈0. 05）,while no difference asso-ciated with the patients′gender, age, primary disease and fistula blood flow was found.