维持性血液透析患者动-静脉内瘘长期通畅率分析  

An analysis of long-term patency rate of internal arteriovenous fistula in maintenance hemodialysis patients

作　　者：刘平[1] 张文[1] 方志军[1] LIU Ping;ZHANG Wen;FANG Zhijun(Department of Hemodialysis,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210028,CHINA)

机构地区：[1]南京中医药大学附属中西医结合医院血透室,江苏210028

出　　处：《江苏医药》2022年第9期943-947,共5页Jiangsu Medical Journal

摘　　要：目的 分析维持性血液透析患者动-静脉内瘘(AVF)长期通畅率以及性别和年龄对AVF长期通畅率的影响。方法 回顾性分析2003年5月—2020年12月使用AVF作为血管通路进行维持性血液透析的246例患者临床资料。采用Kaplan-Meier生存曲线分析患者AVF长期通畅率。比较不同性别、年龄患者AVF长期通畅率的差异。结果 246例患者AVF初级通畅时间为28.5(13.0,57.0)个月,初级功能通畅时间为26.0(11.8,56.0)个月,累积通畅时间为42.0(21.0,81.0)个月,累积功能通畅时间为41.0(19.0,79.3)个月。患者1年、2年、5年、10年的AVF初级通畅率分别为95.1%、79.0%、65.3%、50.8%,初级功能通畅率分别为84.1%、77.8%、64.1%、50.9%,累积通畅率分别为97.9%、94.0%、73.2%、46.4%,累积功能通畅率分别为97.9%、93.9%、73.1%、46.3%。女性患者AVF初级通畅率、初级功能通畅率、累积通畅率、累积功能通畅率均低于男性患者(P<0.05)。年龄≤65岁患者AVF累积通畅率、累积功能通畅率高于年龄>65岁患者(P<0.05),而不同年龄患者AVF初级通畅率、初级功能通畅率比较无统计差异(P>0.05)。结论随着透析时间的延长,维持性血液透析患者的AVF长期通畅率明显下降。女性和年龄>65岁患者AVF长期通畅率低于男性和年龄≤65岁患者。Objective To analyze the long-term patency rate of internal arteriovenous fistula(AVF) in the patients undergoing maintenance hemodialysis and the effects of gender and age on the long-term patency rate of AVF.Methods The clinical data of 246 patients using AVF as vascular access for maintenance hemodialysis from May 2003 to December 2020 were retrospectively analyzed.Kaplan-Meier survival curve was used to analyze the long-term patency rate of AVF.The differences of long-term patency rates of AVF between male and female patients and different ages were compared.Results The primary patency time, primary functional patency time, cumulative patency time and cumulative functional patency time of AVF in 246 patients were 28.5(13.0,57.0) months, 26.0(11.8,56.0) months, 42.0(21.0,81.0) months and 41.0(19.0,79.3) months, respectively.The primary patency rates of 1-,2-,5-and 10-year AVF were 95.1%,79.0%,65.3% and 50.8%,respectively.The primary functional patency rates of 1-,2-,5-and 10-year AVF were 84.1%,77.8%,64.1% and 50.9%,respectively.The cumulative patency rates of 1-,2-,5-and 10-year AVF were 97.9%,94.0%,73.2% and 46.4%,respectively.The cumulative functional patency rates of 1-,2-,5-and 10-year AVF were 97.9%,93.9%,73.1% and 46.3%,respectively.The primary patency rate, primary functional patency rate, cumulative patency rate and cumulative functional patency rate of AVF in female patients were lower than those in male patients(P<0.05).The cumulative patency rate and cumulative functional patency rate of AVF in the patients aged ≤65 years old were higher than those in the patients aged >65 years old(P<0.05).The primary patency rate and primary functional patency rate of AVF were not significantly different between the patients aged ≤65 years old and those aged >65 years old(P>0.05).Conclusion With prolonged dialysis duration, the long-term patency rate of AVF in maintenance hemodialysis patients is significantly decrased.The long-term patency rate of AVF is lower significantly in female patients and the patient

关 键 词：血液透析 动-静脉内瘘 长期通畅率 

分 类 号：R692[医药卫生—泌尿科学]