不同类型血管通路在维持性血液透析患者中的应用效果

Application Effect of Different Types of Vascular Access in Maintenance Hemodialysis Patients

目的:探讨不同类型血管通路在维持性血液透析(maintenance hemodialysis,MHD)患者中的应用效果。方法:回顾性分析2019年12月—2021年12月蚌埠医学院第二附属医院收治的60例MHD患者的临床资料,依据不同血管透析通路将患者分为自体动静脉内瘘(autostatic arteriovenous fistula,AVF)组(n=32)与带隧道涤纶套导管(tunneled cuffed catheter,TCC)组(n=28)。比较两组透析前后钙磷代谢、毒素清除情况、微炎症状态及并发症等。结果:两组透析前后血钙、血磷、血肌酐、尿素氮水平比较,差异无统计学意义(P>0.05)。AVF组透析后C反应蛋白(CRP)、白细胞介素-6(IL-6)水平低于TCC组,差异有统计学意义(P<0.05)。AVF组并发症发生率低于TCC组,差异有统计学意义(P<0.05)。结论:AVF与TCC在毒素清除及维持钙磷代谢方面无明显差异,但AVF可更好地改善MHD患者的微炎症状态,且并发症发生率较低。

Objective:To investigate the application effect of different types of vascular access in maintenance hemodialysis(MHD)patients.Method:The clinical data of 60 MHD patients who admitted to the Second Affiliated Hospital of Bengbu Medical College from December 2019 to December 2021 were retrospectively analyzed,the patients were divided into autostatic arteriovenous fistula(AVF)group(n=32)and tunneled cuffed catheter(TCC)group(n=28)according to different vascular dialysis pathways.The Calcium and Phosphorus metabolism,toxin clearance,microinflammatory state before and after dialysis and complications were compared between two groups.Result:There were no significant differences in serum calcium,serum phosphorus,serum creatinine and urea nitrogen levels between two groups before and after dialysis(P>0.05).The levels of C-reactive protein(CRP)and interleukin-6(IL-6)in the AVF group after dialysis were lower than those in the TCC group,and the differences were statistically significant(P<0.05).The incidence of complications in the AVF group was lower than that in the TCC group,the difference was statistically significant(P<0.05).Conclusion:There are no significant differences between AVF and TCC in toxin clearance and maintenance of calcium and phosphorus metabolism,but AVF can better improve the micro-inflammatory state of MHD patients,and the incidence of complications is low.