腕部桡动脉- 头静脉内瘘通畅的影响因素研究

Factors affecting patency of wrist radiocephalic arteriovenous fistula

摘要:

目的 分析影响终末期肾脏疾病（ESRD）维持性血液透析患者自体动静脉瘘（AVF）通畅性的 因素。方法 选取2016 年12 月—2018 年1 月于中南大学湘雅医院肾内科行腕部桡动脉- 头静脉标准内瘘 手术ESRD 患者195 例。分析其人口统计学资料、临床资料、生化指标及术后应用抗凝治疗是否与AVF 通 畅相关。结果 195 例患者随访1 年，8 例患者失访，4 例患者死亡，行肾移植手术者12 例，29 例患者出现 术后并发症。AVF 的1 年生存率为91.6%。多因素Cox 比例风险模型分析中，抗凝史[Hl ^ R=3.412（95% CI ： 1.225，9.503），P =0.019] 是AVF 通畅的影响因素。结论 术后应用抗凝治疗会降低AVF 的1 年通畅率。

Abstract:

Objective To analysis the possible factors related to the patency of arteriovenous fistula (AVF) in end-stage renal disease (ESRD) patients with dialysis. Methods This prospective study included 195 cases with AVFs at Xiangya Hospital of Central South University from December 2016 to January 2018. All relevant demographic data, clinical information, laboratory parameters and anticoagulant drugs used after operation that could affect the function and the patency of AVF were evaluated. Results 195 patients were followed up for 1 year; 8 patients were lost to follow-up; 4 patients died; 12 patients transplanted; 29 patients had complications. The patency rate for 1 year was 91.6%. In the multiple Cox proportional hazard models, anticoagulant therapy (Hl ^ R=3.412, 95% CI=1.225, 9.503) was significantly associated with the patency of AVF. Conclusions Using anticoagulant drugs can reduce the 1-year patency rate of AVF.