不同部位行动静脉内瘘手术的影响因素分析  

Analysis on influencing factors of different placements of arteriovenous fistula

作　　者：张莹[1] 古英明[1] 李强[2] 黄莹[1] 肖龙[1] 蔡杨[1] 

机构地区：[1]广州医科大学附属第二医院肾内科,510260 [2]广州医科大学附属第二医院血管外科,510260

出　　处：《国际医药卫生导报》2014年第19期2957-2960,共4页International Medicine and Health Guidance News

摘　　要：目的通过对在我院行动静脉内瘘（AVF）手术并长期进行维持性血液透析患者的手术部位及相关因素进行分析，以探讨影响AVF手术部位的主要原因。方法2012年1月至2013年12月在我院行AVF手术患者89例，记录患者的一般情况（性别、年龄、糖尿病、高血压、BMI≥25、吸烟）及临床资料（血红蛋白、血小板、血肌酐、尿素氮、尿酸、钙、磷、全段甲状旁腺激素、白蛋白、总胆固醇、高密度脂蛋白、低密度脂蛋白、甘油三酯、纤维蛋白原、INR）。依手术部位分为腕部AVF组68例和肘部AVF组21例，并对两组的影响因素进行比较。结果肘部AVF组的女性比例、合并糖尿病的人数、年龄、纤维蛋白原均高于腕部AVF组（P〈0．05）。二分类Logistic回归分析示合并糖尿病是对选择肘部手术有显著影响的变量（OR=6．034，P=0．032）。结论选择不同部位行AVF手术应综合考虑患者是否合并糖尿病、是否绝经期妇女、年龄及血液纤维蛋白原升高等因素，以提高手术的成功率。Objective To analyze the different placement of arteriovenous fistula （AVF） in hemodialysis patients and to explore the related influencing factors. Methods Eighty-nine patients underwent AVF operation from January 2012 to December 2013. Gender, age, diabetes, hypertension, BMI ≥ 25, smoke, hemoglobin, platelet, serum creatinine, blood urea nitrogen, uric acid, calcium, phosphorus, intact parathyroid hormone, albumin, cholesterol, high density lipoprotein, low density lipoprotein, triglyceride, fibrinogen, INR were collected. According to the placement of AVF, the patients were divided into wrist fistula group （n=68） and elbow fistula group （n=21）. Statistical analysis was made and compared between the two groups. Results The number of female, with diabetes, age, fibrinogen in elbow fistula group were higher than those in wrist fistula group （P 〈 0.05）. Binary Logistic Regression analysis showed that diabetes could significantly influence the placement of AVF （OR=6.034, P=0.032）. Conclusion Selecting the placements of AVF should consider the following conditions of patients, such as diabetes, whether they were menopausal women or not, their ages and higher blood fibrinogen, in order to improve the success rate of operation.

关 键 词：动静脉内瘘 血液透析 糖尿病 

分 类 号：R654.3[医药卫生—外科学]