中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (05): 259-263.doi: 10.3969/j.issn.1671-4091.2013.05.00

• 临床研究 • 上一篇    下一篇

高龄血液透析患者首次自体动静脉内瘘成形术后内瘘的开放率分析研究

叶红,武晓春,曹红娣,仲华,宋宗纬,汤兵,杨俊伟   

  1. 南京医科大学第二附属医院肾脏病医学中心
  • 收稿日期:2012-11-12 修回日期:2013-01-16 出版日期:2013-05-12 发布日期:2013-07-01
  • 通讯作者: 杨俊伟jwyang@njmu.edu.cn E-mail:jwyang@njmu.edu.cn

The clinical observation of the survival of the first autologous arteriovenous fistula in the elderly hemodialysis patients

  • Received:2012-11-12 Revised:2013-01-16 Online:2013-05-12 Published:2013-07-01

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摘要： 目的 本研究主要分析老年尤其是70岁以上的高龄血液透析患者首次行自体AVF术后内瘘的开放率情况。方法：依据手术时患者的年龄，将其分为两组：高龄组：年龄≥70岁，61例；青壮年组：18岁≤年龄≤55岁，64例。随访18月，记录患者的基本临床资料、手术方式、术后AVF的初级、次级开放率等指标。结果：青壮年组的自体AVF中58例为前臂AVF，6例为上臂AVF（9.3%），高龄组的自体AVF中44例为前臂AVF，17例为上臂AVF（27.9%）。高龄组26例患者合并糖尿病（42.6%），较青壮年组明显升高（14.1%）。（P<0.001）两组自体AVF术后的初级、次级开放率无统计学差异。单因素和多因素分析显示，糖尿病是影响术后AVF初级、次级开放率的主要因素。结论：高龄组患者首次自体AVF术后内瘘开放率较青壮年组无显著差别，糖尿病是影响自体AVF术后内瘘开放率的主要因素。

关键词: 自体动静脉内瘘, 高龄, 开放率

Abstract: Objective: To analyzes the opening rate of the first autologous arteriovenous fistula (AVF) in elderly hemodialysis (HD) patients, especially those more than 70 years old. Methods: According to the age, HD patients were divided into two groups: the elderly group: age≥70 years, 61 cases; the young group: 18 years≤age≤55 years old, 64 cases. Followed by18 months, the clinical data, surgical approach, primary and secondary opening rate of AVF were recorded. Results: In the young group, wrist autologous AVF was established in 58 cases, while elbow autologous AVF was done in 6 cases (9.3%). In the elderly group, wrist autologous AVF was established in 44 cases, while elbow autologous AVF was done in 17 cases (27.9%). The prevalence of diabetes mellitus in the elderly group was 42.6% (26/64), significantly higher than the young group (14.1%). (P <0.001) There was no significant difference of the primary and secondary opening rate of autologous AVF between the two groups. Both univariate analysis and multivariate analysis showed that diabetes mellitus was a major factor to the primary and secondary opening rate of the autologous AVF. Conclusion: There is no significant difference of the opening rate of autologous between the young group and the elderly group. Diabetes mellitus is the main factor affecting the opening rate of the AVF.

Key words: autologous arteriovenous fistula, the elderly, opening rate