血液透析患者动静脉内瘘晚期失功影响因素的分析  

A logistic regression analysis on the influence factors for late arteriovenous fistula dysfunction in hemodialysis patients

作　　者：牛洪艳[1] 刘金凤[1] 杨凤妹[1] 黄竹君[1] 包峥 

机构地区：[1]江苏省常州市第一人民医院血液净化中心,常州市213003

出　　处：《中国血液净化》2016年第9期498-500,共3页Chinese Journal of Blood Purification

摘　　要：目的 探讨血液透析患者动静脉内瘘晚期失功的影响因素,为针对性的干预提供依据。方法抽取某医院血液透析患者127例,对其一般资料及内瘘功能进行横断面调查。以内瘘是否为二分类因变量,患者一般资料及内瘘相关指标为自变量,运用非条件Logistic回归分析方法探讨内瘘失功的影响因素。结果 内瘘失功患者43例（33.9%）;单因素分析透析时间〉10年失功率高于≤10年的血液透析患者,差异有统计学意义（χ2=4.409,P=0.036）;Logistic回归分析结果示透析时间（OR=4.343,95%CI1.269-14.860,P=0.019）、血红蛋白（OR=4.710,95%CI 1.278-17.367,P=0.020）、超滤量（OR=1.001,95%CI 1.000-1.002,P=0.017）及钙磷乘积（OR=3.191,95%CI 1.179-8.634,P=0.022）是内瘘失功的危险因素（P〈0.05）。结论 医护人员应加强内瘘维护意识,定期监测相关实验室指标,并及时调整用药;同时,加强患者及家属健康宣教,提高治疗依从性。Objective To analyze the risk factors for the late arteriovenous fistula （AVF） dysfunction in maintenance hemodialysis （MHD） patients. Methods A transectional survey on 127 MHD patients was carried out about their demographical data and the AVF function. Unconditional logistic regression analysis was carried out to explore the influential factors for AVF dysfunction using the AVF function as the dependent variables and patients＇ demographical data and AVF-related factors as the independent variables. Results There were 43 （33.9%） patients with AVF dysfunction. The rate of dysfunction was higher in patients with the MHD duration of 〉10 years than those of 〈10 years （2;=4.409, P=-0.036）. Hemodialysis duration （0R=4.343, 95% CI 1.2694 14.860, P=-0.019）, hemoglobin （OR=4.710, 95% CI 1.278- 17.367, P=0.020）, ultrafiltration volume （OR=1.001, 95% CI 1.000-1.002, P=0.017）, and calcium-phosphate product （OR=3.191, 95% CI 1.179-8.634, P=0.022） were the risk factors for AVF dysfunction. ConcLusions Medical professionals should pay more attention to take care of the AVF, to monitor the AVF, and to regulate medications when nec- essary. Education for patients and their family members are also very important to enhance the compliance of the patients.

关 键 词：血液透析 动静脉内瘘 失功 LOGISTIC回归分析 

分 类 号：R318.16[医药卫生—生物医学工程]