维持性血液透析患者动静脉内瘘闭塞原因分析及溶栓治疗

Cause analysis and thrombolysis treatment of arteriovenous fistula occlusion in maintenance hemodialysis patients

目的:探讨维持性血液透析患者动静脉内瘘闭塞的引发原因和溶栓治疗效果。方法:收治维持性血液透析治疗患者122例,分为动静脉内瘘堵塞组和动静脉内瘘未堵塞组,回顾性分析患者临床资料,分析溶栓治疗的效果。结果:两组性别、透析频率、三酰甘油、总胆固醇、多囊肾等各类原发病、冠心病差异无统计学意义(P>0.05),两组年龄、体重、头静脉直径、桡静脉直径、纤维蛋白原、血红蛋白、血清蛋白、糖尿病、低血压、频繁穿刺差异有统计学意义(P<0.05)。患者动静脉内瘘堵塞再通时间(34.3±9.8)min,56例患者成功再通,成功率94.92%。结论:维持性血液透析患者动静脉内瘘闭塞与年龄、体重、头静脉直径、桡静脉直径、低血压等因素有重要关联,对患者进行溶栓治疗能显著提升内瘘再通率。

Objective:To explore the causes and effect of thrombolytic therapy of arteriovenous fistula occlusion in maintenance hemodialysis patients.Methods:122 patients with maintenance hemodialysis were selected,they were divided into the arteriovenous fistula occlusion group and arteriovenous fistula non-occlusion group,the clinical data of patients were retrospectively analyzed,and the effect of thrombolytic therapy was analyzed.Results:There was no significant difference in gender,dialysis frequency,triglyceride,total cholesterol,polycystic kidney disease and coronary heart disease between the two groups(P>0.05),there were significant differences in age,body weight,cephalic vein diameter,radial vein diameter,fibrinogen,hemoglobin,serum protein,diabetes mellitus,hypotension and frequent puncture between the two groups(P<0.05).The recanalization time of patients with arteriovenous fistula was(34.3±9.8)minutes,successful recanalization was achieved in 56 patients,the success rate was 94.92%.Conclusion:Arteriovenous fistula occlusion in maintenance hemodialysis patients was associated with age,body mass,cephalic vein diameter,radial vein diameter,hypotension and other factors,thrombolytic therapy can significantly improve the recanalization rate of internal fistula.