自体动静脉内瘘与人造血管内瘘在维持性血液透析患者中的应用价值  

Application Value of Autologous Arteriovenous Fistula and Human Hematopoietic Tube Fistula in Maintenance Hemodialysis Patients

作　　者：张金凤 刘巧梅 马世昌 Zhang Jinfeng;Liu Qiaomei;Ma Shichang(Shangqiu Hospital of Traditional Chinese Medicine,Shangqiu,Henan,476000,China)

机构地区：[1]商丘市中医院,河南商丘476000

出　　处：《黑龙江医学》2024年第9期1070-1072,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨自体动静脉内瘘(AVF)与人造血管内瘘(AVG)对维持性血液透析患者的应用价值,以期提高患者血管再通率、生存周期。方法:选取2019年8月-2021年8月商丘市中医院就诊的96例维持性血液透析患者作为研究对象,根据就诊序号采用电脑随机数表法分为AVF组和AVG组,每组各48例。随访12个月后,比较两组患者血管径路首次通畅率、再次通畅率、血液透析后透析效能,并比较两组患者治疗前、治疗6个月后血清炎性因子[超敏C反应蛋白(hs-CRP)、β2微球蛋白(β2-MG)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平及并发症发生情况。结果:与AVG组比较,AVF组治疗3个月、6个月、12个月血管径路首次通畅率较高,差异有统计学意义(χ^(2)=16.336、12.303、12.462,P<0.05);与AVG组比较,AVF组透析后尿素氮清除指数、尿素氮下降率、血管通路血流量较高,差异有统计学意义(t=5.312、5.857、6.877,P<0.05);治疗6个月后,与AVG组比较,AVF组血清hs-CRP、β2-MG、IL-6、TNF-α水平较低,差异有统计学意义(t=18.581、15.791、34.687、16.336,P<0.05);与AVG组比较,AVF组治疗期间血栓形成、血管瘤、血管狭窄、感染发生率较低,差异有统计学意义(χ^(2)=6.008、4.174、16.232、7.551,P<0.05)。结论:AVF、AVG对于维持性血液透析患者均具有良好效果,其中AVF可作为血管路径首选方案,具有较高血管通畅率,当存在受限因素后,可选取AVG作为内瘘。Objective:To investigate the application value of autologous arteriovenous fistula(AVF)and human hematopoietic tube fistula(AVG)in maintenance hemodialysis patients,in order to improve the vascular revascularization rate and survival cycle of patients.Methods:A total of 96 patients with maintenance hemodialysis who visited the hospital from August 2019 to August 2021 were selected and divided into two groups with computer random number table method according to the visit number,with 48 patients in each group.AVG group received AVG hemodialysis treatment,and AVF group received AVF hemodialysis treatment.After 12 months of follow-up,the first patency rate,the second patency rate and the dialysis efficiency after hemodialysis were compared between the two groups.The levels of serum inflammatory factors,such as hypersensitive C-reactive protein(hs-CRP),β2 microglobulin(β2-mg),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and the incidence of complications were compared between the two groups before treatment and 6 months after treatment.Results:Compared with AVG group,the first patency rate of blood duct path in AVF group was higher in 3 months,6 months and 12 months,with statistically significant difference(χ^(2)=16.336,12.303,12.462;P<0.05).Compared with AVG group,the serum levels of hs-CRP,β2-MG,IL-6 and TNF-αin AVF group were lower after 6 months of treatment(t=5.312,5.857,6.877;P<0.05).Compared with AVG group,the incidence of thrombosis,hemangioma,vascular stenosis and infection was lower in AVF group during treatment(t=18.581,15.791,34.687,16.336;P<0.05).Compared with the AVG group,the incidence of thrombosis,hemangioma,vascular stenosis and infection was lower in the AVF group during treatment,and the difference was statistically significant(χ^(2)=6.008,4.174,16.232,7.551;P<0.05).Conclusion:Both AVF and AVG have good effects on maintenance hemodialysis patients,among which AVF can be used as the preferred vascular pathway with a higher vascular patency rate.When there are limited factors,AVG can be

关 键 词：自体动静脉内瘘 人造血管内瘘 维持性血液透析 

分 类 号：R446.11[医药卫生—诊断学]