自体动静脉内瘘并发症发生的相关影响因素研究  

Related factors for complications of autogenous arteriovenous fistula

作　　者：李进[1] 黄丽红 鄢建军 张仲华 徐钢[1] Li Jin;Huang Li-hong;Yan Jian-jun;Zhang Zhong-hua;Xu Gang(Affiliated Tongji Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《临床肾脏病杂志》2023年第5期396-402,共7页Journal Of Clinical Nephrology

摘　　要：目的 探寻自体动静脉内瘘(arteriovenous fistula,AVF)并发症发生的显著影响因素,为拟定减少AVF并发症发生的干预措施提供依据。方法 采取方便抽样方法,选取2018年10月1日至2018年12月31日在湖北省17家透析中心行维持性血液透析治疗的成年患者1065例。收集患者一般资料、透析龄、原发病、透析频次、首次透析使用通路类型、目前透析使用通路类型、与结局相关的指标。结果 AVF发生并发症400例,logistic多因素回归分析显示,7个显著影响因素与AVF并发症发生有关,分别为:年龄范围为18~40岁、透析龄≤60个月、血泵速度、透析频次1周1次和一周3次、血管选择腕部桡动脉-头静脉和肱动脉-肘正中静脉、区域穿刺法和扣眼穿刺法、穿刺针间的距离<5 cm和穿刺针间的距离≥8 cm及<10 cm。结论 可以针对影响AVF发生并发症的7个因素制定干预措施,减少AVF并发症的发生。Objective To explore the significant influencing factors of arteriovenous fistula(AVF)complications and provide rationales for taking intervention measures for lowering the complications of AVF.Methods From October 1,2018 to December 31,2018,a total of 1065 patients on maintenance hemodialysis(MHD)were recruited from 17 dialysis centers in a province.Baseline profiles,including hemodialysis age,primary kidney disease,dialysis frequency,type of initial dialysis access,type of current dialysis access and prognostic parameters were recorded.Results A total of 400 cases of AVF complications occurred.Multivariate Logistic regression analysis revealed that seven significant influencing factors were related with the occurrence of AVF complications:age 18-40 years,dialysis age≤60 months,blood pump speed,dialysis frequency once/thrice a week,vascular selection of wrist radio-cephalic fistulas and brachial artery to median cubital vein fistula,area puncture method and buttonhole puncture method,distance between puncture needles<5 cm and distance between puncture needles≥8 cm and<10 cm.Conclusions Many complex factors affect the occurrence of AVF complications.How to maintain an ideal vascular access,extend its patency and reduce the occurrence of complications are the common concerns of all blood purification medical staff and patients.

关 键 词：自体动静脉内瘘 并发症 影响因素分析 

分 类 号：R459.5[医药卫生—治疗学]