中国血液净化

›› 2011, Vol. 10 ›› Issue (02): 74-76.doi: 10.3969/j.issn.1671-4091.2011..00

• 临床研究 • 上一篇    下一篇

维持性血液透析患者自体动静脉内瘘低血流量的影响因素分析

江 峡 傅建群   

  1. 广东省佛山市南海区第二人民医院
  • 收稿日期:2010-08-16 修回日期:1900-01-01 出版日期:2011-02-12 发布日期:2011-02-12

Analysis of the factors relating to the low blood flow in autogenous arteriovenous fistula in maintenance hemodialysis patients

JIANG Xia, FU Jian-qun   

  1. The Second People’s Hospital of Nanhai District, Foshan City, Guangdong Province, Foshan 528251, China
  • Received:2010-08-16 Revised:1900-01-01 Online:2011-02-12 Published:2011-02-12

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摘要： 目的 探讨维持性血液透析(maintenance hymodialysis,MHD)患者自体动静脉内瘘低血流量的影响因素，为临床早期干预提供依据。 方法 选择广东省佛山市南海区第二人民医院肾内科2006年6月至2009年12月自体动静脉内瘘MHD患者159例，对其中21例因瘘管低血流量不能改善，导致透析不充分者，进行量化年龄、性别、原发病、内瘘成熟度、低血压、通路血管血栓、内瘘狭窄等指标，并与133例正常血流量组比较，采用二分类logistic回归分析。 结果 159例中21例出现低血流量，发生率13.21%。与正常血流量组比较年龄、体质量指数、原发病、低血压、通路血管血栓、内瘘狭窄、内瘘成熟度和内瘘使用时间，差异均有统计学意义(均P＜0.05)。 结论 体质量指数、糖尿病、通路血管血栓、内瘘使用时间是影响瘘管低血流量非常重要的因素。早期改善患者营养状态，定期监测内瘘情况，可提高自体动静脉内瘘血流量。

关键词: 维持性血液透析, 自体动静脉内瘘, 低血流量, 影响因素

Abstract: Objective To study the factors relating to the low blood flow in autogenous arteriovenous fistula (AVF) in maintenance hemodialysis (MHD) patients, and to find out useful clues to early clinic intervention. Methods A total of 159 MHD patients with autogenous AVF and treated in this hospital from Jun, 2006 to Dec, 2009 were included in this study. In 21 cases of these patients, disease condition could not be improved by MHD due to inadequate vascular access resulting from low blood flow in AVF. Age, sex, body mass index, primary disease, fistula maturity, hypotension, vascular access thrombosis, fistula narrow index and fistula usage time that may relate to the failure of AVF were collected in these patients and compared with those in the other 133 cases with normal blood flow in AVF using binary logistic regression analysis. Results Low blood flow in AVF was found in 21 (13.21%) patients. Age, body mass index, primary disease, low blood pressure, vascular access thrombosis, fistula stenosis, fistula maturity and fistula usage time were significantly different between patients with low blood flow in AVF and those with normal blood flow in AVF (P<0.05). Conclusion Body mass index, diabetes, vascular access thrombosis and fistula usage time are important factors relating to blood flow in AVF in MHD patients. Improvement of patient’s nutritional status and regularly monitoring the AVF situation can be helpful for the adequate blood flow in AVF.

Key words: Autogenous AVF, Low blood flow, Related factors