慢性肾功能衰竭透析患者动静脉内瘘侧上肢功能障碍发生的相关因素

Related Factors of Upper Limb Dysfunction on the Side of Arteriovenous Fistula in Dialysis Patients with Chronic Renal Failure

目的分析慢性肾功能衰竭透析患者动静脉内瘘侧上肢功能障碍发生的影响因素。方法选取2018年4月至2020年8月于南阳市第一人民医院接受血液透析的206例慢性肾功能衰竭患者作为研究对象,设计患者基线资料调查表,统计动静脉内瘘侧上肢功能障碍发生情况,记录研究所需资料,将可能的影响因素纳入,经单因素、多因素分析找出慢性肾功能衰竭透析患者动静脉内瘘侧发生上肢功能障碍的影响因素。结果206例慢性肾功能衰竭透析患者中,18例发生动静脉内瘘侧上肢功能障碍,发生率为8.74%;两组高血压史、内瘘口钙化、内瘘与起搏器同侧比较,差异有统计学意义(P<0.05)。经logistic回归分析结果显示,高血压史、内瘘口钙化、内瘘与起搏器同侧是慢性肾功能衰竭透析患者发生动静脉内瘘侧上肢功能障碍的危险因素(OR>1,P<0.05)。结论慢性肾功能衰竭透析患者发生动静脉内瘘侧上肢功能障碍受高血压史、内瘘口钙化、内瘘与起搏器同侧等因素影响。

Objective To analyze the influencing factors of upper limb dysfunction on the side of arteriovenous fistula in dialysis patients with chronic renal failure.Methods A total of 206 patients with chronic renal failure who underwent hemodialysis in Nanyang First People’s Hospital from April 2018 to August 2020 were selected as the research subjects.The patient baseline data questionnaire was designed,and the occurrence of upper limb dysfunction on the side of arteriovenous fistula was counted,the data required for the study were recorded,included possible influencing factors,the influencing factors of upper limb dysfunction on the side of arteriovenous fistula in dialysis patients with chronic renal failure were found out by univariate and multivariate analysis.Results Among 206 dialysis patients with chronic renal failure,18 had upper limb dysfunction on the side of internal venous fistula,and the incidence was 8.74%.There were statistical differences on hypertension history,internal fistula calcification,internal fistula ipsilateral to pacemaker between the two groups(P<0.05).Through logistic regression analysis,the results showed that history of hypertension,calcification of internal fistula,internal fistula ipsilateral to pacemaker were the risk factors of upper limb dysfunction on the side of arteriovenous fistula in dialysis patients with chronic renal failure(OR>1,P<0.05).Conclusion The dysfunction of upper limb on the side of arteriovenous fistula in dialysis patients with chronic renal failure is affected by the history of hypertension,calcification of internal fistula,internal fistula ipsilateral to pacemaker.