上肢袢形人工血管动静脉瘘通畅率的影响因素分析  

Clinical Applications of Upper Limb Arteriovenous Loop Graft and Risk Factors of Patency Loss

作　　者：熊礼佳[1] 吴潮清[1] 王浩宇[1] 张燕飞[1] 唐业莹[1] 覃宗蕙[1] 

机构地区：[1]广西壮族自治区人民医院

出　　处：《大众科技》2019年第11期63-65,共3页Popular Science & Technology

基　　金：广西卫生和计划生育委员会自筹课题（Z2016598）

摘　　要：目的:分析上肢袢形人工血管动静脉瘘(arteriovenous graft,AVG)通畅率的影响因素。方法:回顾性分析2016年1月至2017年12月广西壮族自治区人民医院肾内科实施19例AVG手术的终末期肾病(end stage of renal disease,ESRD)患者临床资料,应用t检验和Fisher确切概率法比较闭塞组与通畅组临床指标差异,探讨影响AVG通畅率的因素。结果:上肢AVG的6个月和1年初级通畅率均为84.2%,次级通畅率分别为57.8%、63.1%。通畅组和闭塞组组间比较发现年龄、性别、透析龄、多次通路失功史、收缩压(systolic BP,SBP)、舒张压(diastolic BP,DBP)、血白蛋白(serumAlbumin,Alb)、血钙(serum calcium,Ca)、血磷(serum phosphorus,P)、血甲状旁腺素(intact parathyroid hormone,iPTH)差异无统计学意义(P>0.05),吸烟史、CRP、P差异有统计学意义(P<0.05)。结论:有吸烟史、高CRP、高P血症是影响AVG通畅率的高危因素。Objective: This study aimed to assess primary patency rates of arteriovenous graft and the risk factors of patency loss. Methods: A total of 19 patients who needed AVG for hemodialysis in our department from January 2016 to December 2017 were retrospectively reviewed. Clinical data and patency rates were obtained in a retrospective manner. Statistical analysis was performed with the T test and Fisher’s exact test. Results: The primary patency rates were 84.2% both at 6 months and 1 year. The secondary patency rates were 57.8% at 6 months, but 63.1% at one-year. There was no significant difference in age, gender, duration of dialysis, SBP, DBP, serum albumin, calcium, intact parathyroid hormone between AVG with patency loss and AVG without patency loss(P>0.05). Meanwhile, smoking, multiple vascular access failure, CRP and serum phosphorus were significantly associated with primary patency rates. Conclusion: Various factors were associated with the development of patency loss of AVG, such as smoking, multiple vascular access failure, CRP and serum phosphorus.

关 键 词：人工血管动静脉瘘 通畅率 高危因素 

分 类 号：R654[医药卫生—外科学]