96例维持性血液透析患者长期中心静脉导管生存及其影响因素分析  

Survival and its influencing factors of central venous catheter in 96 patients with maintenance hemodialysis

作　　者：王博[1] 孙桂江[1] 于海波[1] 贾岚 姜埃利[1] WANG Bo;SUN Gui-jiang;YU Hai-bo;JlA Lan;JlANG Ai-li(Department of Kidney Disease and Blood Purification,The Second Hospital,Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院肾脏病血液净化科,天津300211

出　　处：《天津医科大学学报》2018年第6期509-512,共4页Journal of Tianjin Medical University

基　　金：国家自然科学基金资助项目(81600591)

摘　　要：目的:探讨维持性血液透析患者长期中心静脉导管(CVC)生存时间及其影响因素。方法:选取2012年1月-2013年12月于我院初次行颈内静脉长期导管置入术的96例患者,从数字化管理系统中获取患者CVC自建立之初至4年末的临床资料,采用Kaplan-Meier方法绘制患者CVC的生存曲线,并用COX模型进一步分析影响CVC的生存因素。结果:CVC1年生存率95.8%,2年生存率86.46%,3年生存率71.86%,4年生存率53.13%;导管感染组、糖尿病组CVC生存率低,尿激酶间断封管是CVC生存的保护因素,差异具有统计学意义。糖尿病(HR:2.263;95%CI:1.210-4.230)、导管感染(HR:2.040;95%CI:1.056-3.942)、低白蛋白(HR:0.878;95%CI:0.795-0.969)是CVC生存危险因素。结论:糖尿病、导管相关感染(CRI)、低白蛋白是降低CVC使用寿命的危险因素。Objective： To explore the survival time and its risk factors for central venous catheter （CVC）of patients with maintenance hemodialysis. Methods： A cohort study regarding 96 cases that insertedCVCs in our center for the first time from January 2012 to December 2013was retrospectively performed.The clinical data of these patients from the CVC created four years later was obtained from digital management system. Kaplan-Meier survival curves and Cox proportional hazard models were used to determine the service life and related factors. Results： The survival rates for 1,2,3,4years were 95.8%,86.46%,71.86% or 53.13%.The diabetes group, catheter infections group have lower CVC survival rate, rokinase intermittentlyinstead of heparin as a locking solutiongroup had higher CVC survival rate, the difference had statistically significance.The risk factors for CVC survival were diabetes （HR：2.263;95%CI：1.210-4.230）,catheter infections （HR：2.040;95%CI： 1.056-3.942）, and Ioweralbumin （HR：0.878;95%CI：0.795-0.969）. Conclusion： Diabetes, CRI and Iowerserum albumin may be the main risk factors for CVC survival.

关 键 词：肾透析 中心静脉 导管插入 生存分析 危险因素 

分 类 号：R692.5[医药卫生—泌尿科学]