Current status of aneurysmal dilatation at puncture segment of arteriovenous fistula in maintenance hemodialysis patients and its influencing factors:a 306-case study
Objective To investigate the current status of aneurysmal dilatation at the puncture segment of arteriovenous fistula in 306 maintenance hemodialysis patients and to analyze its influencing factors.Methods Using convenience sampling,306 maintenance hemodialysis patients were selected from three tertiary grade-A hospitals in Guangzhou from September 2022 to March 2023.They were divided into aneurysmal dilatation group(n=37)and non-aneurysmal dilatation group(n=269)according to whether aneurysmal dilatation occurred in the puncture segment of arteriovenous fistula.The binary logistic regression was used to analyze the risk factors of aneurysmal dilatation of puncture segment.Results The incidence of aneurysmal dilatation at the puncture segment of arteriovenous fistula was 12.1%in 306 maintenance hemodialysis patients.Binary logistic regression analysis showed that fistula duration longer than 32 months,a history of area puncture,brachial artery flow greater than 1200 ml/min and anastomotic diameter greater than 4mm were risk factors for aneurysmal dilatation at the puncture segment of arteriovenous fistula in maintenance hemodialysis patients(P＜0.05).Conclusion Longer fistula duration,the history of area puncture,higher blood flow of brachial artery and larger anastomotic diameter are major risk factors for aneurysmal dilatation at the puncture segment of arteriovenous fistula.It is suggested that blood purification nurses should avoid area puncture,focus on the fistula with long duration of use,high brachial artery blood flow and large anastomotic diameter,and take targeted preventive or reactive measures to delay the development of aneurysmal dilatation at the puncture segment.
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