动静脉内瘘和带袖套隧道导管对于血透的充分性和并发症比较

目的通过比较不同血管通路对于血透患者的充分性和并发症，探讨持续血液透析患者理想的血管通路。方法选择我院肾内科2011年1月-2012年4月开始进行规律血液透析的患者，随访12-28月，评估动静脉内瘘（AVF）和带袖套隧道导管（CTC）的Kt/V值，比较二者并发症发生率。结果67例患者中，采用AVF的41例，CTC的26例：AVF组的年龄和感染发生率比CTC组低（P〈0.05）；二者的Kt/V值均〉1.2，但AVF组高于CTC组（P〈0.05）。结论 AVF组患者年龄轻、感染发生率低，应是长期血管通路的首选，CTC在AVF无法建立时可作为较好的长期血管通路。

Comparison of dialsyis adequacy and access-related complication of native arteriovenous fistula and cuffed and tunneled catheter

Objective To compare the dialsyis adequacy and access-related complication of native arteriovenous fistula and cuffed and tunneled catheter, and try to find out an iedal vascular access approach. Methods Patients who underwent an operation of long-term hemodialysis access between Jan. 2011 and Apr. 2012 were inrolled in this study. Kt/V and the morgidity of access -related complications were evaluated and compared in a follow-up period of 12-28 months between patients using vascular access of native arteriovenous fistula（AVF） and patients of cuffed and tunneled catherte（CTC） in an internal jugular vein. Results In the 67 maintenance hemodialysis patients, 41 cases were used native AVF and 26 cases used CTC as the long-term vascular access for hemodialysis. Compared with CTC group, the patients of native AVF group were yonhger and had lower infection rate（P〈0.05）. Kt/V value was more than 1.2 in both groups, but was higher in native AVF group, compared with that of CTC group（P〈0.05）. Conclusion Patients using native AVF for hemodialysis were younger and had lower rate of infection. Native AVF is preferable for long-term vasvular access. With relatively satisfactory effect of dialysis, CTC can also be chosen when native AVF is difficult to be established.