上海市单中心糖尿病血液透析血管通路调查分析  

The investigation of vascular access for diabetic patients in a hemodialysis center in Shanghai

作　　者：冯雪芳[1] 周蓉[1] 徐雅虹[1] 蒋茜[1] 陈闽东[1] 沈杰[1] 

机构地区：[1]同济大学附属杨浦医院肾内科,上海200090

出　　处：《中国血液净化》2016年第8期430-432,共3页Chinese Journal of Blood Purification

摘　　要：目的回顾性对比分析单中心合并糖尿病与非糖尿病的维持性血液透析患者血管通路使用及并发症情况。方法以同济大学附属杨浦医院血液透析中心维持性透析患者为研究对象,根据有无糖尿病分为2组,自2015年1月1日起,观察期为1年,对比分析2组患者血管通路使用情况及相关并发症。结果研究纳入患者188名,其中糖尿病组72人（38.3%）,非糖尿病组116人（61.7%）,2组患者首次透析使用临时导管比例均高于长期导管及动静脉内瘘,非糖尿病组首次透析使用动静脉内瘘比例高于糖尿病组（35.3%比18.0%,χ^2=6.486,P=0.011）。长期血管通路方面糖尿病组长期导管使用率高于非糖尿病组（26.4%比13.8%,χ^2=4.652,P=0.031）。2组内瘘血泵流量分层比较无显著差异（χ^2=0.149,P=0.928）;两组长期导管血泵流量分层比较无显著差异（χ^2=2.283,P=0.244）。糖尿病组的内瘘血栓形成和/或狭窄发生率高于非糖尿病组（19.6%6.30%,χ^2=4.335,P=0.037）,血管通路感染发生率也高于非糖尿病组（16.7%比4.3%,χ^2=8.247,P=0.004）。结论本中心的维持性血透患者首次透析临时导管使用率高于长期导管及内瘘,糖尿病组以长期导管为血管通路的比例较高,观察期内血管通路并发症发生率也高于非糖尿病组。Objective To retrospectively compare the vascular access between diabetic and non-diabetic maintenance hemodialysis （MHD） patients in a center in Shanghai. Method We compared the type and function of vascular access between diabetic and non-diabetic MHD patients treated in Yangpu Hospital in 2015. The complications relating to blood access were recorded as well. Result We recruited 188 MHD patients including 116 non-diabetic MHD patients and 72 diabetic MHD patients for this investigation. Temporary catheter was used in most diabetic and non-diabetic patients for the first hemodialysis, and fistula was used more in non-diabetic patients than in diabetic patients for the first hemodialysis. The blood flow volume was the same between non-diabetic and diabetic patients. The prevalence of infection, thrombosis and stenosis relating to vascular access was higher in diabetic patients than in non-diabetic patients. Conclusion Most patients used temporary catheters at the beginning of hemodialysis. More diabetic patients used long-term catheters as the permanent vascular access than non-diabetic patients in our center. The prevalence of complications relating to vascular access was higher in diabetic patients than in non-diabetic patients.

关 键 词：糖尿病 血管通路 并发症 

分 类 号：R318.16[医药卫生—生物医学工程]