Degradable magnesium alloy suture promotes fibrocartilaginous interface regeneration in a rat rotator cuff transosseous repair model

Despite transosseous rotator cuff tear repair using sutures is widely accepted for tendon-bone fixation,the fibrocartilaginous enthesis regeneration is still hardly achieved with the traditional sutures.In the present work,degradable magnesium(Mg)alloy wire was applied to suture supraspinatus tendon in a rat acute rotator cuff tear model with Vicryl Plus 4±0 absorbable suture as control.The shoulder joint humerus-supraspinatus tendon complex specimens were retrieved at 4,8,and 12 weeks after operation.The Mg alloy suture groups showed better biomechanical properties in terms of ultimate load to failure.Gross observation showed that hyperplastic response of the scar tissue at the tendon-bone interface is progressively alleviated over time in the both Mg alloy suture and Vicryl suture groups.In the histological analysis,for Mg alloy suture groups,chondrocytes appear to proliferate at 4 weeks postoperatively,and the tendon-bone interface showed an orderly structural transition zone at 8 weeks postoperatively.The collagenous fiber tended to be aligned and the tendon-bone interlocking structures apparently formed,where transitional structure from unmineralized fibrocartilage to mineralized fibrocartilage was closer to the native fibrocartilaginous enthesis.In vivo degradation of the magnesium alloy wire was completed within 12 weeks.The results indicated that Mg alloy wire was promising as degradable suture with the potential to promotes fibrocartilaginous interface regeneration in rotator cuff repair.

Effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries

BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries.METHODS We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023.Patients were grouped using the envelope method.RESULTS After treatment,the study group’s treatment effective rate was 94.90%(46/49 patients),significantly higher than that in the control group(79.17%,38/48 cases;P<0.05).Before treatment,there was no difference in Constant Murley Score(CMS)scores,shoulder mobility,or 36-Item Short Form Health Survey(SF-36)scale scores(P>0.05).Compared with those before treatment,the CMS scores(including pain,daily living ability,shoulder mobility,and muscle strength),all aspects of shoulder mobility(forward flexion,posterior extension,external rotation,internal rotation),and SF-36 scale scores(including physiological,psychological,emotional,physical,vitality,and health status)were higher in both groups after treatment and significantly higher in the study group(P<0.05).There was no difference in the occurrence of complications between the two treatment groups(P>0.05).CONCLUSION Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries,helps accelerate the recovery of shoulder function,improves the quality of life,and is highly safe.

Application of multidisciplinary team-based integrated traditional Chinese medicine and Western medicine in rotator cuff injury patients undergoing arthroscopic surgery

BACKGROUND Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries(RCIs).Although this procedure has certain clinical advantages,it requires rehabilitation management interventions to ensure therapeutic efficacy.AIM To investigate the effect of integrated traditional Chinese medicine and Western medicine(TCM-WM)under the multidisciplinary team(MDT)model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs.METHODS This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024.They were divided into a control group(n=48)that received routine rehabilitation treatment and an experimental group(n=52)that received TCM-WM under the MDT model(e.g.,acupuncture,TCM traumatology and orthopedics,and rehabilitation).The results of the Constant–Murley Shoulder Score(CMS),Visual Analogue Scale(VAS),Shoulder Pain and Disability Index(SPADI),muscular strength evaluation,and shoulder range of motion(ROM)assessments were analyzed.RESULTS After treatment,the experimental group showed significantly higher CMS scores in terms of pain,functional activity,shoulder joint mobility,and muscular strength than the baseline and those of the control group.The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group.In addition,the experimental group showed significantly enhanced muscular strength(forward flexor and external and internal rotator muscles)and shoulder ROM(forward flexion,abduction,and lateral abduction)after treatment compared with the control group.CONCLUSION TCM-WM under the MDT model improved shoulder joint function,relieved postoperative pain,promoted postoperative functional recovery,and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.

多层螺旋CT上腔静脉三维成像技术在评估Cuff导管植入术后导管功能障碍中的应用价值

目的探讨多层螺旋CT上腔静脉三维成像技术在Cuff导管植入术后评估导管功能障碍中的应用价值。方法回顾性分析2019年5月至2021年8月海军第九七一医院因慢性肾衰竭行双腔带Cuff导管留置术,且术后出现导管功能障碍并接受CT上腔静脉三维成像(上腔静脉CTV)的20例患者的临床资料。上述患者中进行颈部血管彩超者13例、数字减影血管造影(DSA)检查者7例。将上腔静脉CTV结果、彩超结果、DSA检查结果进行比较分析。结果20例接受CT上腔静脉三维成像检查者中,CT图像清晰显示导管植入不同血管的位置,明确显示了导管尖端所在位置。呈现Cuff导管的情况分别为:周围血栓致功能障碍15例,导管滑脱2例,植管后皮下隧道疼痛2例,无明显症状1例。行颈部彩超检查的13例中,仅有1例显示头臂静脉上段血栓形成,5例显示颈部静脉管腔扩张或内径略小或仅有细小血流通过,余7例未显示。行DSA检查7例,均用于分析长期血液透析导管血流量减低及造瘘后肿胀手的原因、DSA引导下重新植管及长期血液透析导管纤维鞘去除术等诊疗应用。结论改良的上腔静脉CT三维成像技术空间分辨率高、可重复性强,能立体直观地显示血液透析患者Cuff导管植入血管位置、尖端所在位置、血管通路是否有血栓形成等情况。颈部血管彩超仅作为粗略评价之用;DSA为有创检查,更倾向用于临床治疗。上腔静脉CTV在敏感性、特异性及检查范围上都有较大优势,是评估Cuff导管植入术后导管功能障碍原因中优先选择的检查方法。

Ultrasound of the Rotator Cuff in Non-Fractured Shoulder Trauma: 30 Cases at the Yalgado Ouedraogo University Hospital of Ouagadougou (Burkina Faso)

Introduction: Ultrasound is the imaging technique of choice for the study of rotator cuff lesions. However, in the case of shoulder trauma, it is rarely requested in our context. This study aimed to show ultrasound lesions of the rotator cuff in cases of non-fracture shoulder trauma at the CHUYO in Ouagadougou. Methodology: This was a prospective descriptive cross-sectional study running from August 1 to November 30, 2017, in the medical imaging department of CHUYO. The study population consisted of patients received in the department for ultrasound in the context of non-fracture shoulder trauma. Results: We collected 20 cases (66.67%) of rotator cuff lesions out of 30 non-fracture shoulder injuries. The mean age of the patients was 27.6 years. Road traffic accidents accounted for 60% of injuries, sports accidents for 30%, and domestic accidents for 10%. Ultrasound lesions were mainly tendon ruptures (36.67%) and tendinitis (23.33%). Ruptures were non-transfixing in 90.90% of cases. The supraspinatus was the most affected (81.81%). Conclusion: Ultrasound can help diagnose rotator cuff injuries, particularly in non-fractured shoulder trauma.

Long head of biceps tendon transposition for massive and irreparable rotator cuff tears:A systematic review and meta-analysis

BACKGROUND Superior capsular reconstruction(SCR)with long head of biceps tendon(LHBT)transposition was developed to massive and irreparable rotator cuff tears(MIRCTs);however,the outcomes of this technique remain unclear.AIM To perform a systematic review of biomechanical outcomes and a meta-analysis of clinical outcomes after LHBT transposition for MIRCTs.METHODS We performed a systematic electronic database search on PubMed,EMBASE,and Cochrane Library.Studies of SCR with LHBT transposition were included according to the inclusion and exclusion criteria.Biomechanical studies were assessed for main results and conclusions.Included clinical studies were evaluated for quality of methodology.Data including study characteristics,cohort demographics,and outcomes were extracted.A meta-analysis was conducted of the clinical outcomes.RESULTS According to our inclusion and exclusion criteria,a total of six biomechanical studies were identified and reported an overall improvement in subacromial contact pressures and prevention of superior humeral migration without limiting range of motion(ROM)after LHBT transposition for MIRCTs.A total of five clinical studies were included in the meta-analysis of LHBT transposition outcomes,consisting of 253 patients.The results indicated that compared to other surgical methods for MIRCTs,LHBT transposition had advantages of more significant improvement in ROM(forward flexion mean difference[MD]=6.54,95%confidence interval[CI]:3.07-10.01;external rotation[MD=5.15,95%CI:1.59-8.17];the acromiohumeral distance[AHD][MD=0.90,95%CI:0.21-1.59])and reducing retear rate(odds ratio=0.27,95%CI:0.15-0.48).No significant difference in American Shoulder and Elbow Surgeons score,visual analogue scale score,and University of California at Los Angles score was demonstrated between these two groups for MIRCTs.CONCLUSION In general,SCR with LHBT transposition was a reliable and economical technique for treating MIRCTs,both in terms of biomechanical and clinical outcomes,with comparable clinical outcomes,improved ROM,AHD,and reduced the retear rates compared to conventional SCR and other established techniques.More high-quality randomized controlled studies on the long-term outcomes of SCR with LHBT transposition are required to further assess.

Rotator cuff repair with an interposition polypropylene mesh:A biomechanical ovine study

BACKGROUND Chronic large to massive rotator cuff tears are difficult to treat and re-tears are common even after surgical repair.We propose using a synthetic polypropylene mesh to increase the tensile strength of rotator cuff repairs.We hypothesize that using a polypropylene mesh to bridge the repair of large rotator cuff tears will increase the ultimate failure load of the repair.AIM To investigate the mechanical properties of rotator cuff tears repaired with a polypropylene interposition graft in an ovine ex-vivo model.METHODS A 20 mm length of infraspinatus tendon was resected from fifteen fresh sheep shoulders to simulate a large tear.We used a polypropylene mesh as an interposition graft between the ends of the tendon for repair.In seven specimens,the mesh was secured to remnant tendon by continuous stitching while mattress stitches were used for eight specimens.Five specimens with an intact tendon were tested.The specimens underwent cyclic loading to determine the ultimate failure load and gap formation.RESULTS The mean gap formation after 3000 cycles was 1.67 mm in the continuous group,and 4.16 mm in the mattress group(P=0.001).The mean ultimate failure load was significantly higher at 549.2 N in the continuous group,426.4 N in the mattress group and 370 N in the intact group(P=0.003).CONCLUSION The use of a polypropylene mesh is biomechanically suitable as an interposition graft for large irreparable rotator cuff tears.

Effects of different positions on rehabilitation after rotator cuff repair under shoulder arthroscopy

Objective Shoulder arthroscopic rotator cuff tear repair is currently the main treatment for full-thickness rotator cuff tears,and postoperative rehabilitation training is essential.However,pain and limitation of activity during the rehabilitation process will lead to poor results.Hence,identifying rehabilitation approaches is crucial.This study aimed to compare patient's rehabilitation outcomes and experience between rehabilitation in the supine position and in the standing position.Methods This prospective study included patients diagnosed with full-thickness rotator cuff tears who underwent shoulder arthroscopic double-row rivet repair at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine from March 2019 to September 2021.The patients were randomly assigned to the standing rehabilitation exercise group(group A)and the supine rehabilitation exercise group(group B).All patients were followed up for 6 months to record and compare the visual analog scale(VAS)scores,shoulder range of motion,and rehabilitation compliance.Results Altogether,86 patients participated in the study,of whom 79 patients completed the 6-month follow-up.Groups A and B had 39 and 40 patients,respectively.Before operation,the VAS score,forward flexion and extension angle,and abduction angle were comparable between groups A and B.After operation,the patients in groups A and B all experienced a significant improvement in the VAS score,forward flexion and extension angle,and abduction angle(p<0.05).In addition,patients in group B had better VAS score(4.58±0.87 vs.5.21±1.13,p=0.0068;2.15±0.66 vs.2.51±0.51,p=0.0078;0.78±0.86 vs.1.33±0.81,p=0.0015),forward flexion and extension angle(109.30±2.87°vs.102.33±3.74°,p=0.0001;109.53±3.39°vs.104.18±2.76°,p=0.0001;125.22±6.05°vs.117.59±2.27°,p=0.0001),and abduction angle(91.78±2.77°vs.82.92±2.12°,p=0.0001;91.62±2.78°vs.82.82±1.45°,p=0.0001;109.48±3.37°vs.100.10±2.94°,p=0.0001)at 2 wk,6 wk and 6 m postoperatively.Conclusion After 6 months of follow-up,the patients who performed rehabilitation exercises in the supine position achieved better rehabilitation outcomes than those who performed rehabilitation exercises while standing.

Role of platelet-rich plasma in the treatment of rotator cuff tendinopathy

Shoulder pain is a common musculoskeletal complaint,and rotator cuff(RC)pathologies are one of the main causes.The RC undergoes various tendinopathic and avascular changes during the aging process.Other degenerative changes affecting its healing potential make it an appealing target for biological agents.Platelet-rich plasma(PRP)has demonstrated the potential to deliver a high concentration of several growth factors and anti-inflammatory mediators,and its clinical use is mainly supported by experiments that demonstrated its positive effect on muscle,ligaments,and tendinous cells.This review aimed to specify the role of PRP and its future applications in RC tendinopathies based on the current clinical evidence.Due to the different characteristics and conflicting outcomes,clinicians should use PRP with moderate expectations until more consistent evidence is available.However,it is reasonable to consider PRP in patients with contraindications to corticosteroid injections or those with risk factors for inadequate healing.Its autologous origin makes it a safe treatment,and its characteristics make it a promising option for treating RC tendinopathy,but the efficacy has yet to be established.

Bilateral dislocation of the long head of biceps tendon with intact rotator cuff tendon:A case report

BACKGROUND Dislocation of the long head of biceps tendon(LHBT)usually involves rotator cuff injury,and isolated dislocation with an intact rotator cuff is rare.Some cases of isolated dislocation have been reported.However,to the best of our knowledge,there has been no report of bilateral dislocation of the LHBT without rotator cuff pathology.CASE SUMMARY A 23-year-old male presented to our outpatient clinic with left side dominant pain in both shoulders.The patient had no history of trauma or overuse.The patient underwent intra-articular injection and physical therapy,but his symptoms aggravated.Based on preoperative imaging,the diagnosis was bilateral dislocation of the LHBT.Dysplasia of the bicipital groove was detected in both shoulders.Active dislocation of the biceps tendon over an intact subscapularis tendon was identified by diagnostic arthroscopy.Staged biceps tenodesis was performed and continuous passive motion therapy was administered immediately after surgery.The patient’s pain was resolved,and full functional recovery was achieved,and he was satisfied with the condition of his shoulders.CONCLUSION This study describes a rare case of bilateral dislocations of the LHBT without rotator cuff injury due to dysplasia of the bicipital groove.

Pressure changes in tapered and cylindrical shaped cuff after extension of head and neck:A randomized controlled trial

BACKGROUND The proper cuff pressure of endotracheal tube(ET)plays an important role in sealing the airway and preventing airway complications during mechanical ventilation.The ET cuff shape affects the cuff pressure after positional change.AIM To investigate cuff pressure between tapered and cylindrical cuff after extension of head and neck during nasal endotracheal intubation.METHODS In a randomized clinical trial,52 patients were randomized to one of two groups:cylindrical cuff or Tapered cuff.Cuff pressure with 22 cmH_(2)O was applied to patients in the neutral position.After extension of head and neck,the cuff pressure was evaluated again and readjusted to 22 cmH_(2)O.In addition,the extent of cephalad migration of ET tip was assessed and postoperative airway complications such as sore throat,and hoarseness were measured.RESULTS The cuff pressure was higher in the tapered cuff(28.7±1.0 cmH_(2)O)than in the cylindrical cuff(25.5±0.8 cmH_(2)O)after head and neck extension(P<0.001).The extent of cephalad migration of tube tip was greater in TaperGuard ET(18.4±2.2 mm)than in conventional ET(15.1±1.2 mm)(P<0.001).The incidence of postoperative airway complications was comparable between two groups.CONCLUSION After head and neck extension,the cuff pressure and the extent of cephalad migration of ET was greater in tapered cuff than in cylindrical cuff during nasal intubation,respectively.

不同浓度肝素封管液在带cuff的深静脉留置导管中的应用研究

目的观察采用不同浓度肝素液进行带cuff的深静脉留置导管封管对规律血液透析患者凝血功能、出血倾向、导管血栓形成等的影响,探讨合理的封管浓度。方法将60例带cuff的深静脉留置导管作为维持性血液透析血管通路的患者随机分为3组(n=20)。A组:纯肝素钠封管(6 250 U/mL);B组:中浓度肝素钠(4 088 U/mL)和生理盐水溶液;C组:低浓度肝素钠(3 125 U/mL)和生理盐水溶液。测定封管后24、h凝血指标,监测出血倾向、通路血栓形成、感染等情况。结果 A组在封管后2 h及4 h时凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、国际标准化比值(INR)等凝血功能指标均较基础值显著延长(P<0.01)。B组患者封管2 h后仅PT、APTT显著超过基础值(P<0.05),且在4h后恢复至基础水平(P>0.05)。C组患者封管后PT、APTT和INR与基础值比较,差异均无统计学意义(P>0.05)。观察期1个月,C组患者出血事件发生率显著低于A、B组(P<0.05),3组间血栓发生率、感染率、导管拔出率均无显著差异。结论低浓度肝素钠溶液进行带cuff的深静脉留置导管封管不良反应较少,可用于大多数患者。有高凝倾向的患者更适合采用中浓度肝素液。

Clinical Decision Making in Open vs Arthroscopic Rotator Cuff Repair: Evidence for Preoperative Decision Making

Objective: To further understand what factors should be considered when deciding to do mini-open versus arthroscopic rotator cuff repair. Methods: A systematic literature search on the computer was done with the help of the PubMed database. Of the articles searched through, three have been chosen to specifically address topics of interest concerning the factors affecting arthroscopic vs mini-open RCR surgical approaches. Discussion: As we continue to progress down the line of factors impacting a clinician’s decision making, we begin to see how postoperative management is unchanged. Tear severity lacks sufficient evidence to base a decision on, but financial, educational, and logistical factors are proven to play a significant role in this decision. Conclusion: As of right now it seems that mini-open RCR is the most cost and time efficient method, especially amongst non-fellowship trained surgeons or ones with lower volume of shoulder scopes. However, further studies should be done to examine cost and efficiency in Sport Medicine fellowship trained orthopedic surgeons to validate these findings.

cuff管套入法建立大鼠同种异体睾丸移植模型

目的:探索应用cuff管套入法建立大鼠同种异体睾丸移植模型的新方法。方法:60只健康雄性近交系W istar大鼠分别作为供、受体,显微镜下(×10),连同左侧供睾的动、静脉一起截取与其相连的腹主动脉段和左髂总静脉段,以丝线结扎左髂总静脉段的远断端,其余3断端分别套上cuff管后袖套状翻转并以丝线环扎之,然后分别将外套cuff管的动、静脉嵌入切开的受鼠的腹主动脉内和左髂总静脉内后再环扎,端端吻合受、供体输精管,摘除受鼠双侧睾丸。结果:30只大鼠正式手术,27只长期存活直至处死,2只死于麻痹性肠梗阻伴感染,1只因术中大出血死亡。27只长期存活的受体中,4、4、5例于术后14 d、28 d、56 d探查植睾,血供情况良好,关腹存活至处死;余14只用于其他实验。受体左下肢术后无明显水肿、淤血和坏死。结论:应用cuff管技术建立的大鼠睾丸移植模型具有操作简便、成功率高、效果可靠等优点,可作为睾丸移植的研究模型。

带Cuff中心静脉导管在维持性血液透析患者中的应用价值

血管通路是透析患者的“生命线”,对血液透析患者至关重要。自体动静脉内瘘有血栓形成率低、感染率低等优点,是目前血管通路建立的首选方案 [1] 。随着人口老龄化和糖尿病、高血压的发病率升高,老年肾脏病、糖尿病性肾病、高血压性肾病患者逐年增加,其中越来越多的患者因自身血管条件差而无法行自体动静脉造瘘手术,或因心功能不全而无法耐受内瘘,需要尝试其他的血管通路。

血流量大小对带cuff中心静脉导管血液透析患者透析充分性的影响

目的观察血流量大小对带cuff中心静脉导管血液透析患者透析充分性的影响。方法将15例带cuff中心静脉导管维持血液透析患者的血流量设为200ml/min,透析12次后再设为250ml/min,透析12次后进入洗脱期,设为200ml/min透析24次,再设为300ml/min透析12次。每次透析4h,每周3次。观察每种血流量时的单室模型Kt/V(spKt/V)、尿素清除率(URR),观察试验前、后血红蛋白、红细胞压积、心功能的变化。结果随着血流量的增加,spKt/V和URR值越高,透析越充分。血流量分别为200ml/min、250ml/min、300ml/min时的spKt/V值分别为(1.44±0.04)、(1.58±0.05)、(1.85±0.20)(1.44比1.58,1.44比1.85,均P<0.05),URR值分别为(69.01%±3.88%)、972.23%±4.26%)、(76.06%±4.82%)(69.01%比72.23%,69.01%比76.06%,均P<0.05)。试验后的血红蛋白和血红细胞压积较试验前增加(107.60g/L比92.20g/L,31.65fl比28.53fl,均P<0.05)。试验前后的射血分数EF%、每搏输出量(SV)、心室舒张末期容积(EDV)、心室收缩末期容积(ESV)的差异均没有统计学意义(均P>0.05)。结论带cuff中心静脉导管血液透析患者随着血流量的增加,透析越来越充分,不会对心功能产生明显不良影响,且可以改善贫血状况。

带CUFF中心静脉导管作为血液透析通路的临床分析

目的 总结留置带CUFF中心静脉导管的经验,探讨如何防治带CUFF中心静脉导管的并发症。方法 分析1996年3月～2001年3月我院对20例患者留置带CUFF中心静脉导管25例次。其中,右侧颈内静脉留置导管8例次、左侧颈内静脉留置导管2例次、右侧锁骨下静脉留置导管12例次、左侧锁骨下静脉留置导管3例次。结果 主要并发症:导管位置不当4例次;感染的发生率为32％(8/25),平均1.3例次/1000天,治疗有效率为25％(2/8);血栓的发生率为24％(6/25),导管内血栓治疗的有效率为75％(3/4)。总的带管时间为201个月,从2～27个月,平均带管时间为8个月。结论 带CUFF中心静脉导管对于长期血液透析治疗而无血管通路或不能承受动静脉内瘘的患者是必不可少的,其并发症是可以防治的。

带cuff的中心静脉导管接头破损原因分析及护理对策

目的探讨带cuff的中心静脉导管接头破损的原因及护理对策。方法收集52例带cuff的中心静脉导管发生接头破损的相关资料,分析原因并提出护理对策,以处理和预防破损的再发生。结果接头破损的主要原因包括接头外侧螺纹口不清洁、接头过度拧接、接头对合不齐等;针对原因提出防范措施。更换52例破损接头,未发现有渗血、漏气等现象,未出现再次更换接头和感染的情况。结论接头破损原因与季节、护士操作不当有很大的关系。规范护理人员操作、选择合适的用物,可预防接头破损的发生。在严格无菌操作的前提下,更换接头的处理是可行的。

颈内静脉隧道式Cuff血液透析导管移位的相关因素分析

目的探索维持性血液透析患者(Maintenance hemodialysis patient,MHP)使用颈内静脉隧道式Cuff血液透析导管发生移位的相关因素,为临床Cuff血液透析导管置入定位和护理提供参考意见。方法对我院使用颈内静脉隧道式Cuff血液透析导管的186例次MHP进行回顾性分析,收集患者的一般资料(年龄、性别、原发疾病等),生化指标(血肌酐、尿素氮、血清白蛋白等),人体测量指标(肱三头肌皮褶厚度、上臂肌围、肌肉组织质量等),根据置入导管是否有移位分为A组(移位组)和B组(未移位组),比较两组患者上述临床资料差异,进行Logistic回归分析。结果A组56例(30.1%),B组130例(69.9%)。Cuff血液透析导管移位单因素分析显示:两组患者的年龄、C-反应蛋白、血清白蛋白、蛋白质分解率、肱三头肌皮褶厚度、上臂肌围、肌肉组织质量和肌肉组织指数比较,差异均有统计学意义(P<0.05)。Logistic回归分析,患者年龄、C-反应蛋白是发生Cuff血液透析导管发生移位的危险因素(OR=1.062,OR=1.206,P均<0.05)。上臂肌围、肌肉组织质量是发生Cuff血液透析导管发生移位的保护因素(OR=0.976,OR=0.791,P均<0.05)。结论建议高龄、微炎状态、上臂肌围小、肌肉组织质量小的患者在放置颈内静脉隧道式Cuff血液透析导管时Cuff距离皮肤出口的距离适当增加或适当延长导管拆线时间。血液透析期间加强患者护理营养干预有助于降低Cuff血液导管移位风险。