维持性血液透析患者内瘘使用寿命及失功原因分析

目的分析西部地区血液透析患者的动静脉内瘘使用情况以及内瘘失功的常见原因。方法回顾性分析了我中心维持性血液透析患者92例。平均透析时间（38.5±30.8）个月。每周接受2~3次血液透析,均采用绳梯斜行穿刺。统计这些患者内瘘的使用时间、失功原因及影响因素。结果 92例患者均采用动静脉端侧吻合的方式。初次内瘘6年的存活率为80%。其中共有12例初次内瘘失功,平均使用时间为11.6个月。失功原因分别为：血栓形成7例,内瘘狭窄5例。这些患者中有11例再行第2次内瘘,其中有3例血栓形成及1例内瘘狭窄行第3次内瘘手术。多因素分析显示糖尿病是影响内瘘失功的主要因素。结论维持性血液透析患者内瘘的6年存活率为80%。内瘘失功的主要原因是血栓形成与内瘘狭窄。糖尿病是主要影响因素。

The survival of arterioveneous fistula in maintenance hemodialysis patients and its influencing factors

Objective To investigate the application of arterioveneous fistula（AVF）in hemodialysis patients and the common causes of fistula dysfunction.Methods Arterioveneous fistulas of 92 patients with maintained hemodialysis were studied by retrospective analysis.Arterioveneous fistula was built by end-to-side anastomosis between cephalic vein and radial artery in the unaccustomed-used forearm.Information of the time of the fistula surgery,the potency of the fistula and period of fistula dysfunction was collected and further analzed.Results The survival rate of AVF was 80% in the first 6 years.Fistula dysfunction was found in 12 cases（13.0%）.The average survival of the 12 AVFs was 11.6 months.Thrombosis and stenosis were the two main causes of AVF dysfunction.The diabetes mellitus was the main risk factor for AVF dysfunction.Conclusion The survival rate of AVF was 80% in the first 6 years.Thrombosis and stenosis were the two main causes of AVF dysfunction.The diabetes mellitus was the main risk factor.