维持性血液透析患者选择不同血管通路对心功能及预后的影响研究

Effects of Different Vascular Access on Cardiac Function and Prognosis in Patients With Maintenance Hemodialysis

目的分析应用不同血管通路对于维持性血液透析患者的心功能以及预后的影响。方法选择本院于2017年6月-2019年1月收治的80例维持性血液透析患者作为研究对象,按照血管通路选择的不同将所有研究对象分为研究组(应用动静脉瘘血管通路)与对照组(应用长期导管续观通路)各40例。统计对比两组患者临床资料与左心室功能状况,记录患者尿素清除率以及1年内心血管事件引起的死亡情况;统计分析两组患者生活质量评分情况。结果研究组患者一般资料与对照组相比不具有显著差异(P> 0.05);研究组患者左心室收缩功能障碍以及左心室肥厚的发生情况与对照组相比具有显著差异(P <0.05);研究组患者尿素清除率与对照组患者相比不具有显著差异(P> 0.05);研究组患者心血管事件引起的死亡率与对照组相比不具有显著差异(P>0.05);研究组患者各项生活质量评分与对照组相比具有显著差异(P <0.05)。结论应用动静脉瘘进行血液透析的患者左心室功能障碍发生率更高,在治疗过程中需要注意血红蛋白水平、舒张压以及原发疾病等危险因素的控制。

Objective To analyze the effects of different vascular access on cardiac function and prognosis in patients with maintenance hemodialysis. Methods 200 patients with maintenance hemodialysis admitted to our hospital from June 2017 to January 2019 were selected as the study subjects. All subjects were divided into study group(application of arteriovenous fistula access) and control group(application of long-term ductal continuation access) according to the different selection of vascular access. The clinical data and left ventricular function of the two groups were statistically compared, and the urea clearance rate and the death caused by cardiovascular events within 1 year were recorded. Results There was no significant difference between the general data of the study group and the control group(P > 0.05);there was significant difference between the study group and the control group in the occurrence of left ventricular systolic dysfunction and left ventricular hypertrophy(P < 0.05);there was no significant difference in the urea clearance rate between the study group and the control group(P > 0.05);the death caused by cardiovascular events in the study group There was no significant difference between the death rate and the control group(P > 0.05);the quality of life scores of the patients in the study group were significantly different from those in the control group(P < 0.05). Conclusion The incidence of left ventricular dysfunction in hemodialysis patients with arteriovenous fistula is higher, so it is necessary to pay attention to the control of hemoglobin level, diastolic blood pressure, primary disease and other risk factors during the treatment.