尿毒症血液透析患者动静脉内瘘血流量对心功能的影响  

Effect of Internal Arteriovenous Fistula Blood Flow on the Cardiac Function of Patients with Uremia Hemodialysis

作　　者：梁兴澜 陈勇平[1] LIANG Xing-lan;CHEN Yong-ping(Department of Nephrology,Longyan Second Hospital,Longyan,Fujian Province,364000 China)

机构地区：[1]福建省龙岩市第二医院肾内科,福建龙岩364000

出　　处：《中外医疗》2017年第35期40-41,50,共3页China & Foreign Medical Treatment

摘　　要：目的探究动静脉内瘘血流量大小对尿毒症维血液透析患者心功能指标的影响。方法方便选择2015年1月—2016年1月福建省龙岩市第二医院肾内科利用动静脉内瘘行维持性血液透析的90例慢性肾衰竭患者作为研究对象,依据AVFB测量值分为3组,超过600 m L/min命名为高流量组(29例);400~600 m L/min之间的命名为中流量组(33例);不足400 m L/min患者命名为低流量组(28例)。比较3组患者透析前、后CO、CI、EF以及高危事件发生率和内瘘失功能发生率。结果高流量组患者高危事件发生率(44.83%)明显高于中、低流量组(18.18%、14.29%),差异有统计学意义(P<0.05)。低流量组患者内瘘失功能发生率(32.14%)明显高于中、高流量组(9.09%、6.90%),差异有统计学意义(P<0.05)。透析前后,高、中、低流量组CO、CI和EF差异有统计学意义(P<0.05)。高流量组各指标值显著高于低流量组和中流量组(P<0.05)。与透析前比较,低流量组透析后与透析前变异不大,中流量组、高流量组CO、CI和EF水平均较透析前升高(P<0.05)。结论动静脉内瘘血流量控制在400~600 m L/min为宜,较好减少对患者心功能造成影响。Objective To study the effect of internal arteriovenous fistula blood flow on the cardiac function of patients with Uremia hemodialysis.Methods 90 cases of chronic renal failure patients with internal arteriovenous fistula for mintenance hemodialysis in our hospital from January 2015 to January 2016 convenient were selected as the research objects and divided into three groups according to the AVFB measurement value,including the high flow group with 29 cases(>600 mL/min),moderate flow group with 33 cases(400~600 mL/min),and the low flow group with 28 cases(<400 mL/min),and the CO,CI,EF,incidence rate of high-risk events and incidence rate of iternal fistula failure before and after dialysis were compared between the three groups.Results The incidence rate of high-risk events in the high flow group was obviously higher than that in the moderate and low flow groups(44.83%vs 18.18%,14.29%),and the difference was statistically significant(P<0.05),and the incidence rate of internal fistula failure n the low flow group was obviously higher than that in the moderate and high flow groups(32.14%vs 9.09%,6.90%),and the differences were statistically significant(P<0.05),and the differences in the CO,CI,EF between the three groups were statistically significant(P<0.05),and various indicators in the high flow group were obviously higher than those in the low flow group and in the moderate flow group(P<0.05),and the difference in the low flow group before and after hemodialysis was not obvious,and the CO,CI and EF in the moderate flow group and high flow group increased compared with those before hemodialysis(P<0.05).Conclusion The blood flow of internal arteriovenous fistula controlled between 400 and 600ml/min is proper,which can better reduce the effect on the cardiac function of patients.

关 键 词：尿毒症 血液透析 动静脉瘘 心功能 

分 类 号：R459[医药卫生—治疗学]