维持性血液透析患者自体动静脉内瘘血栓形成的相关因素
Related factors of autologous arteriovenous fistula thrombosis in maintenance hemodialysis patients
叶星星 1周建芳 1陆晓艳 1姚国明1
作者信息
摘要
目的 探讨维持性血液透析患者自体动静脉内瘘血栓形成的相关因素.方法 选择2017年1月～2022年7月浙江省杭州市中医院血液净化中心首次发生自体动静脉内瘘血栓形成的血液透析患者85例作为内瘘血栓组,按1:2匹配选取同期行自体动静脉内瘘术且内瘘功能良好的无内瘘血栓组170例,根据临床经验并查阅相关文献,收集影响血液透析患者自体动静脉内瘘血栓形成的各种可能因素行单因素及多因素Logistic回归分析.结果 性别、血尿素、hs-CRP、D-二聚体是患者自体动静脉内瘘血栓形成的相关因素.结论 男性、低血尿素、高hs-CRP及高D-二聚体是血液透析患者内瘘血栓形成的危险因素,临床需对男性患者加强内瘘保护宣教,对于血尿素低的患者应加强营养支持,积极治疗炎症及高凝状态,以降低患者内瘘血栓发生率.
Abstract
Objective To explore the related factors of autologous arteriovenous fistula thrombosis in maintenance hemodialysis patients.Method 85 hemodialysis patients who experienced the first occurrence of arteriovenous fistula throm-bosis at the Blood Purification Center of Hangzhou Traditional Chinese Medicine Hospital in Zhejiang Province from January 2017 to July 2022 were selected as the arteriovenous fistula thrombosis group.A group of 170 patients without arteriovenous fistula thrombosis who underwent arteriovenous fistula surgery during the same period and had good fistula function were se-lected according to a 1:2 matching.Based on clinical experience and relevant literature review,various possible factors af-fecting arteriovenous fistula thrombosis formation in hemodialysis patients were collected for univariate and multivariate lo-gistic regression analysis.Results Gender,blood urea,Hs CRP and D-dimer were related factors for the formation of au-tologous arteriovenous fistula thrombosis in patients.Conclusion Male,low blood urea,high h-s-CRP,and high D-dimer are risk factors for the formation of fistula thrombosis in hemodialysis patients.Clinical education on fistula protection should be strengthened for male patients.For patients with low blood urea,nutritional support should be strengthened,inflammation and hypercoagulability should be actively treated to reduce the incidence of fistula thrombosis in patients.
关键词
维持性血液透析/自体动静脉内瘘血栓/影响因素Key words
maintenance hemodialysis/Autogenous arteriovenous fistula thrombosis/influence factor引用本文复制引用
基金项目
浙江省医药卫生科技计划(2021KY922)
出版年
2024
NETL
NSTL
万方数据