血液透析患者原发性动静脉瘘功能障碍的危险因素分析

Analysis of Risk Factors for Primary Arteriovenous Fistula Dysfunction in Hemodialysis Patients

【目的】探讨血液透析患者原发性动静脉瘘(AVF)功能障碍的相关性因素。【方法】选取本院实施血液透析治疗的144例患者进行回顾性分析,根据原犮性AVF功能情况分为功能障碍组(50例)、通畅组(94例),比较两组患者的年龄、体质量指数(BMI)、内瘘使用时间、穿刺方法、血脂指标等基本资料,采用Logistic回归法分析血液透析患者原发性AVF功能障碍的相关性因素。【结果】功能障碍组与通畅组的年龄、性别、BMI、内瘘使用时间、血红蛋白(Hb)、总胆固醇(TC)、D-二聚体(D-D)水平相比较差异无显著性(P>0.05);功能障碍组纽扣式穿刺比例、血栓形成比例高于通畅组,压迫时间长于通畅组,血小板(PLT)、甲状旁腺激素(PTH)、血磷、血清铁蛋白(FER)高于通畅组,三酰甘油(TG)、血钙低于通畅组,且差异具有显著性(P<0.05)。经多因素Logistic回归分析;血栓形成、压迫时间延长、TG增高、血磷增高是血液透析患者原发性AVF功能障碍的独立性危险因素(P<0.05)。【结论】血液透析患者原发性AVF功能障碍的影响因素较多,对TG增高、压迫时间延长、血栓形成、血磷增高的患者予以干预,有利于防止原发性AVF功能障碍的发生。

[Objective]To explore the related factors of primary arteriovenous fistula(AVF)dysfunction in hemodialysis patients.[Methods]A total of 144 patients who underwent hemodialysis in our hospital were retropectively analyzed.According to the functional status of primary AVF,50 patients were in the dysfunc-tion group and 94 patients were in the unobstructed group.The age,body mass index(BMI),internal fistula use time,puneture method and blood lipid index were compared between the 1Wo groups.Logistic regression analysis was used to analyze the related factors of primary AVF dysfunetion in hemodialysis patients.[Results]There were no significant dflerences in age.gender,BMI,duration of internal fistula,Hb,TC,DD of the dysfunction group and the unobstructed group(P>0.05).and the patency group.the thrombosis method.The ratio of button puncture and thrombosis in the dysfunction group was higher than that in the unobstructed group.The time of compression in the dysfunction group was longer than that in the unobstructed group.Lev-elsof PLT,TG,PTH.serum caleium,blood phosphorus and serum FER in the dysfunction group were high-er than those in the unobstructed group.Levels of triacylglyeerol(TG)and serum calcium were in the dysfune-tion group were lower than those in the unobstructed.All those differences were shown statistically significant(P<0.05).Multivariate logistic regression analysis showed that thrombosid,prolonged compression time,inereased TG and blood phosphorus were independent risk factors for primary AVF dysfunction in hemodialy-sis patients(P<0.05).[Conclusion]There are many factors influencing the primary AVF dysfunetion in he-modialysis patients.According to the results of this study,targeted intervention is helpful to prevent the oe-currence of primary AVF dysfunction.