老年透析患者行动静脉内瘘和透析导管对透析充分性及微炎症反应对比研究  

A comparative study on dialysis adequacy and micro-inflammatory response between active venous fistula and dialysis catheter in elderly dialysis patients

作　　者：秦玉萍 路利娟 季帅燕 QIN Yuping;LU Lijuan;JI Shuaiyan(Department of Nephrology,Affiliated RICH Hospital of Nantong University,Nantong City,Jiangsu 226010,China)

机构地区：[1]南通大学附属瑞慈医院肾内科,江苏南通226010

出　　处：《现代医学与健康研究电子杂志》2022年第23期59-62,共4页Modern Medicine and Health Research

摘　　要：目的探究与分析老年透析患者行动静脉内瘘和透析导管对透析充分性及微炎症反应。方法选取2019年3月至2021年8月南通大学附属瑞慈医院收治的老年血液透析患者112例作为研究对象,按照不同的透析血管通路分为内瘘组与导管组,每组各56例,内瘘组给予动静脉内瘘实施血液透析治疗,导管组给予颈静脉半永久导管血液透析治疗,两组均连续治疗3个月,对比两组患者的透析效能、治疗前后微炎症指标、血红蛋白、血清白蛋白、血清铁蛋白,同时对治疗期间并发症进行观察。结果内瘘组与导管组相比尿素氮清除指数较高、尿素氮下降率较高、血管通路血流量较高,差异有统计学意义(P<0.05)。内瘘组治疗后与导管组治疗后相比超敏C反应蛋白(hs-CRP)水平均较低,差异有统计学意义(P<0.05)。内瘘组治疗后与导管组治疗后相比血红蛋白、血清铁蛋白水平均较高,差异有统计学意义(P<0.05)。两组患者治疗期间均未出现明显的不良反应。结论动静脉内瘘实施血液透析治疗可获得更高的透析充分性,可明显促进减轻透析患者的微炎症反应,纠正肾性贫血的发生,同时在治疗期间避免增加并发症,安全性有保障。Objective To explore and analyze the dialysis adequacy and micro-inflammatory response of active venous fistula and dialysis catheter in elderly dialysis patients.Methods A total of 112 elderly dialysis patients admitted to the Affiliated RICH Hospital of Nantong University from March 2019 to August 2021 were selected and divided into an internal fistula group and a catheter group according to different dialysis vascular accesses,with 56 cases in each group,and the internal fistula group was given arteriovenous Internal fistulas were treated with hemodialysis.The catheter group was given jugular vein semi-permanent catheter hemodialysis.Both groups were treated for 3 consecutive months.The dialysis efficacy,micro-inflammatory indexes,hemoglobin,serum albumin,and serum ferritin before and after treatment were compared between the two groups,and complications during treatment were also observed.Results Compared with the catheter group,the internal fistula group had higher urea clearance index,higher blood urea nitrogen decline rate,and higher blood flow through vascular access,and the differences were statistically significant(P<0.05).The level of hs-CRP in the internal fistula group was lower than that in the catheter group after treatment,and the difference was statistically significant(P<0.05).Compared with the catheter group,the levels of hemoglobin and serum ferritin were higher in the internal fistula group after treatment,and the differencs were statistically significant(P<0.05).Conclusion Hemodialysis treatment of arteriovenous fistula can achieve higher dialysis adequacy,can significantly reduce the micro-inflammatory response of dialysis patients,correct the occurrence of renal anemia,and avoid increasing complications during treatment,and the safety is guaranteed.

关 键 词：老年透析 动静脉内瘘 透析导管 透析充分性 微炎症反应 肾性贫血 

分 类 号：R692.5[医药卫生—泌尿科学]