腕部桡动脉-头静脉内瘘通畅的影响因素研究  

Factors affecting patency of wrist radiocephalic arteriovenous fistula

作　　者：刘倩倩 唐旸烁[2] 伍婷 蒲佳曦 陈金彪[3] 肖湘成[1] 周巧玲[1] 肖平[1] 钟永[1] Qian-qian Liu;Yang-shuo Tang;Ting Wu;Jia-xi Pu;Jin-biao Chen;Xiang-cheng Xiao;Qiao-ling Zhou;Ping Xiao;Yong Zhong(Department of Nephrology, Xiangya Hospital, Central South University, Changsha, Hunan 410008,China;Department of Ultrasonography, Xiangya Hospital, Central South University, Changsha,Hunan 410008, China;Department of Medical Records & Information, Xiangya Hospital,Central South University, Changsha, Hunan 410008, China)

机构地区：[1]中南大学湘雅医院肾内科,湖南长沙410008 [2]中南大学湘雅医院超声影像科,湖南长沙410008 [3]中南大学湘雅医院病案信息科,湖南长沙410008

出　　处：《中国现代医学杂志》2019年第16期64-68,共5页China Journal of Modern Medicine

基　　金：湖南省卫生健康委科研计划课题(No:C2019184)

摘　　要：目的分析影响终末期肾脏疾病(ESRD)维持性血液透析患者自体动静脉瘘(AVF)通畅性的因素。方法选取2016年12月-2018年1月于中南大学湘雅医院肾内科行腕部桡动脉-头静脉标准内瘘手术ESRD患者195例。分析其人口统计学资料、临床资料、生化指标及术后应用抗凝治疗是否与AVF通畅相关。结果195例患者随访1年,8例患者失访,4例患者死亡,行肾移植手术者12例,29例患者出现术后并发症。AVF的1年生存率为91.6%。多因素Cox比例风险模型分析中,抗凝史[H^R=3.412(95%CI:1.225,9.503),P=0.019]是AVF通畅的影响因素。结论术后应用抗凝治疗会降低AVF的1年通畅率。Objective To analysis the possible factors related to the patency of arteriovenous fistula (AVF) in end-stage renal disease (ESRD) patients with dialysis. Methods This prospective study included 195 cases with AVFs at Xiangya Hospital of Central South University from December 2016 to January 2018. All relevant demographic data, clinical information, laboratory parameters and anticoagulant drugs used after operation that could affect the function and the patency of AVF were evaluated. Results 195 patients were followed up for 1 year;8 patients were lost to follow-up;4 patients died;12 patients transplanted;29 patients had complications. The patency rate for 1 year was 91.6%. In the multiple Cox proportional hazard models, anticoagulant therapy (H ^ R=3.412, 95% CI=1.225, 9.503) was signi.cantly associated with the patency of AVF. Conclusions Using anticoagulant drugs can reduce the 1-year patency rate of AVF.

关 键 词：动静脉瘘 肾透析 肾病 

分 类 号：R318.16[医药卫生—生物医学工程]