血液透析患者颈内静脉置管相关血栓形成的危险因素

目的观察血液透析患者颈内静脉置管血栓发生率及相关风险因素。方法选择首都医科大学附属北京天坛医院首次使用颈内静脉置管血液透析患者53例，B超检测血栓形成情况并分析颈内静脉置管血栓发生率、病变特点及相关风险因素。结果患者血栓发生率为52．8％（28／53）。糖尿病、高脂血症和高同型半胱氨酸血症患者血栓形成比例均显著性增高，其优势比值分别为3．45（95％CI1．89—18．53），2．69（95％CI2．01～20．21）及2．87（95％CI2．83～15．36）（P〈0．05）。结论糖尿病、高胆固醇血症和高同型半胱氨酸血症是血液透析患者颈内静脉置管血栓发生风险的独立风险因素。

RISK FACTORS OF THROMBOSIS FORMATION ASSOCIATED WITH INTERNAL JUGULAR VENOUS INDWELLING CATHETER IN HEMODIALYSIS PATIENTS

Objective To investigate the prevalence and risk factors of thrombosis formation associated with internal jugular venous indwelling catheter in hemodialysis patients. Methods Fifty-three hemodialysis patients from the hospital, who received the first time the right jugular venous catheter insertion were enrolled in the study. B-mode ultrasound was applied to detect the formation of venous thrombosis, clinical data and biochemical indicators were collected to investigate the prevalence, characteristics and risk factors of venous thrombosis around indwelling catheter. Results The prevalence of central vein thrombosis in this group of hemodialysis patients was 52.8% （28/53 patients）. Six of the 28 thrombosis formation patients presented clinical symptoms, five of them developed edema of the upper extremity and one patient had new onset symptom＇s pulmonary embolism. The odd ratios of diabetes mellitus were respectively 3.45 （95% CI 1.89 - 18.53） ,2.69 （95% CI 2.01 - 20.21 and 2.87 （95% CI 2.83 - 15.36 ）. Conclusion Diabetes mellitus, hypercholesteremia and higher serum homocysteine are independent risk factors of catheter related central vein thrombosis in hemodialysis patients.