早期干预在维持血液透析患者动静脉瘘功能中的临床效果  

Clinical effect of early intervention in the prevention of arteriovenous fistula function in maintaining hemodialysis patients

作　　者：冯婉娟[1] 王培永[1] 陈虎[2] 熊婷[1] Feng Wanjuan;Wang Peiyong;Chen Hu;Xiong Ting(Blood Purification Center,Bengbu First People's Hospital,Bengbu 233000,Anhui,China;Department of Vascular Surgery,Bengbu First People's Hospital,Bengbu 233000,Anhui,China)

机构地区：[1]蚌埠市第一人民医院血液净化中心,安徽蚌埠233000 [2]蚌埠市第一人民医院血管外科,安徽蚌埠233000

出　　处：《血管与腔内血管外科杂志》2022年第9期1135-1139,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨早期干预在维持血液透析(MHD)患者动静脉瘘(AVF)功能中的临床效果。方法收集2019年1月至2021年12月蚌埠市第一人民医院80例建立AVF的MHD患者的临床资料,根据干预方法的不同将其分为常规组(n=40,采用常规干预措施)和早期组(n=40,采用早期干预措施)。比较两组患者的透析质量指标,包括血管通路血流量、血尿素、血肌酐、血尿酸水平。观察两组患者干预前后的心理状态,包括焦虑自评量表(SAS)、抑郁自评量表(SDS)。比较两组患者的生活质量,统计两组患者的并发症发生情况。结果干预后,两组患者血管通路血流量、血尿素、血肌酐、血尿酸均低于本组干预前,但早期组患者血管通路血流量高于常规组患者,血尿素、血肌酐、血尿酸均低于常规组患者,差异均有统计学意义(P<0.05)。干预后,两组患者SAS、SDS评分均低于本组干预前,且早期组患者SAS、SDS评分均低于常规组患者,差异均有统计学意义(P<0.05)。干预后,两组患者36条目健康调查简表(SF-36)各维度评分均高于本组干预前,且早期组患者SF-36各维度评分均高于常规组患者,差异均有统计学意义(P<0.05)。早期组患者术后出血、感染、假性动脉瘤、血栓形成、内瘘狭窄发生率均低于常规组患者,差异均有统计学意义(P<0.05)。结论早期干预能够保障MHD患者的AVF功能,提高患者的透析质量,改善患者的心理状态与透析期间的生活质量,并可有效降低AVF术后并发症发生率,提高术后维持透析期间的安全性。Objective To investigate the effect of early intervention on the clinical effect of controlling arteriovenous fistula(AVF)function in maintaining hemodialysis(MHD)patients.Method The clinical data of 80 MHD patients with AVF in Bengbu First People’s Hospital from January 2019 to December 2021 were collected.They were divided into conventional group(n=40,given conventional intervention)and early group(n=40,given early intervention)according to different intervention methods.The hemodialysis quality indicators,including vascular access blood flow,blood urea,blood creatinine,and blood uric acid levels were compared between the two groups.The psychological states of selfrating anxiety scale(SAS)and self-rating depression scale(SDS)in the two groups before and after the intervention were observed.The quality of life of the two groups of patients was compared,and the incidence of complications of the two groups of patients was also counted.Result After intervention,the blood flow,blood urea,blood creatinine,and blood uric acid of vascular access in the two groups were lower than those before intervention in the same group,while the blood flow of the early group was higher than that of the routine group,the blood urea,blood creatinine,and blood uric acid were lower than those in the routine group,the differences were statistically significant(P<0.05).After intervention,the SAS and SDS scores of the two groups were lower than those before intervention,the SAS and SDS scores of the early group were lower than those of the routine group,the differences were statistically significant(P<0.05).After intervention,the 36-item short-form health survey(SF-36)scores of each dimension in the two groups were higher than those before intervention in the same group,and the scores in the early group were higher than those in the routine group,the differences were statistically significant(P<0.05).The incidence rate of postoperative bleeding,infection,pseudoaneurysm,thrombosis,and internal fistula stenosis in the early group were lowe

关 键 词：维持性血液透析 动静脉瘘 早期干预 透析质量 

分 类 号：R543[医药卫生—心血管疾病]