维持性血液透析患者自体动静脉内瘘失功的影响因素  

Analysis of the influential factors related to dysfunction in arteriovenous fistula on maintenance hemodialysis patients

作　　者：童昌军[1] 谈雅吟[1] 高峰[1] 张卫东[1] 

机构地区：[1]皖南医学院附属弋矶山医院血液净化中心,安徽芜湖241001

出　　处：《皖南医学院学报》2013年第5期382-384,共3页Journal of Wannan Medical College

摘　　要：目的：旨在研究自体动静脉内瘘失功的影响因素，并进一步分析找出导致内瘘失功的主要影响因素，为临床医师早期有效的预防内瘘失功提供参考依据。方法：选择2005年1月～2012年6月在我院首次行自体动静脉内瘘术并长期在我院行维持性血液透析的153例次内瘘手术患者，男76例次，女77例次；患者平均年龄（54±18）岁。我们对患者原发病、血脂水平、血红蛋白水平、血小板计数、钙磷乘积以及间期体质量增长等六项指标进行量化后使用Logistic回归分析。结果：共37例次发生内瘘失功，患者的透析间期体质量增长幅度是其主要影响因素。结论：患者过高的间期体质量增幅、糖尿病为原发病、高水平的LDL、血红蛋白的异常和钙磷乘积的过高都是影响内瘘功能状况的重要因素，维持性血液透析患者应避免高危因素的存在，早期预防危险因素的发生，从而减少内瘘失功的情况发生。Objective：To identify the potential influencing factors associ-ated with arteriovenous fistula （ AVF ） dysfunction in patients undergoing maintenance hemodialysis for early intervention of the failure .Methods：Included were 153 patients undergone maintenance hemodialysis （ MHD） by use of vascular access via initial creation of native upper arm AVF in our hospital between Jan.2005 and Jun.2012.Of the total subjects,76 were males and 77 females with an average age of 54 ±18 years.The baselines were measured and assessed with multivariate logistic regression analysis regarding the primary diseases, serum lipid levels, hemoglobin levels,blood platelet count,calcium-phosphorus product and weight gains at regular hemodialysis intervals.Results：Dysfunctional AVFs occurred in 37 patients,and the major influencing factors were associated with exces-sive weight gain between dialysis .Conclusion：The findings suggest that the risk factors for vascular access failure in dialysis are involved in exces-sive weight gain between dialysis,diabetes as primary condition,higher LDL level, abnormally elevated hemoglobin content and increased calci-um-phosphorus products,which indicates that attention should be paid to the occurrence of risk factors that require early intervention to prevent the dysfunction of AVF for patients in maintenance haemodialysis .

关 键 词：血液透析 内瘘 体质量增幅 

分 类 号：R459.5[医药卫生—治疗学]