德阳地区1550例维持性血液透析患者长期血管通路横断面调查分析

A cross-sectional survey of long-term vascular access in 1,550 patients with maintenance hemodialysis in Deyang area

目的了解德阳市维持性血液透析患者的长期血管通路情况。方法采用横断面调查的方法,分析德阳地区14家血液透析中心2018年6月1日~6月30日接受维持性血液透析患者的基本资料、长期血管通路情况。结果本研究共纳入使用长期血管通路的维持性血液透析患者1550例,其中动静脉内瘘1405例(90.65%),带隧道和涤纶套的透析导管136例(8.77%),移植物动静脉内瘘9例(0.58%)。动静脉内瘘、带隧道和涤纶套的透析导管、和移植物动静脉内瘘的平均使用时间分别为(46.27±36.11)月、(28.69±21.32)月、(27.99±15.27)月。透析通路血流量多集中在200~300ml/min。使用动静脉内瘘的患者中,左侧1019例(72.53%),右侧386例(27.47%)。最常见的吻合血管为桡动脉-头静脉1370例(97.51%),吻合方式绝大多数为端侧吻合(98.08%)。结论德阳地区维持性血液透析患者的长期血管通路以动静脉内瘘为主,中心静脉导管使用比例仍有下调余地。应采取相应措施促进移植物动静脉内瘘的应用与发展,降低中心静脉导管的使用比例。

Objective To investigate the current status of long-term vascular access in maintenance hemodialysis(MHD)patients in Deyang area.Method A cross-sectional survey was conducted to investigate the long-term vascular access of 1,550 MHD patients from 14 hemodialysis centers in Deyang area in the period from June 1 to June 30,2018.Their basic information and vascular access methods were recruited.Results This study enrolled a total of 1,550 MHD patients including 1,405 cases of arteriovenous fistula(AVF,90.65%),136 cases of tunneled cuffed catheter(8.77%)and 9 cases of arteriovenous graft(0.58%).The average service time of AVF,tunneled cuffed catheter and arteriovenous graft were 46.27±36.11 months,28.69±21.32 months and 27.99±15.27 months respectively.The blood flow of most vascular access was in the range of200~300 ml/min.AVF located left side in 1,019 patients(72.53%)and located right side in 386 patients(27.47%).The most common type of AVF was wrist radio-cephalic fistula(97.51%)and end-to-side anastomosis(98.08%).Conclusion AVF was the most common long-term vascular access among MHD patients in Deyang area.We should make effort to lower the proportion of patients using central venous catheter for blood access.The application of arteriovenous graft can reduce the use of central venous catheter.