【摘要】 [目的]回顾性分析我院156例长期维持性血液透析患者(MHD)的病因构成、透析通路选择情况。[方法]对我血液净化中心行血液透析的慢性肾功衰(CRF)患者的性别、年龄、原发病、透析血流通路选择情况及血流情况进行准确的记录,然后进行数据汇总分析。[结果]持性血液透析患者病因构成:各种肾炎/肾病为60.25%,糖尿病为10.89%,高血压为9.76%,结石导致梗阻性肾病为5.72%,多囊肾为1.92%,其他原因为8.92%。透析血路选择自体动静脉造瘘的为58.33%,长期留置导管的为14.1%,颈静脉临时插管的为11.50%,股静脉临时插管的为3.20%,临时插管但已经造瘘的为5.779%,直穿的为6.41%,人工血管1例;长期导管感染率:感染1次的有4例,为长期导管置管的2.56%,感染2次的1例,为0.64%,未发现血栓堵管并发症;人工血管1例,后因血管堵塞改为长期导管;透析生存率1年以内的10.9%,1～2年33.97%;2～4年25%,4～7年21.16%,7～10年7.05%,10年以上1.92%。[结论]慢性肾功衰尿毒症病因构成在我血液净化中心以慢性肾小球肾炎、糖尿病肾病、高血压、梗阻性肾病为四大主要原因;血液透析选择主要还是以自体造瘘为主,临时插管主要为暂时过渡,长期导管有感染、栓塞等并发症,但是对血管条件差,无法行动静脉瘘、血管移植术或人造血管植入术,或手术失败,为一理想的选择。更多还原

【Abstract】 [Objective] To retrospective analyze the etiological composition and hemodialysis access of 156 Long-term maintenance hemodialysis patients in our hospital.[Methods] We accurately record the gender,age,primary disease,dialysis,blood flow and blood flow of channel choice situation of CRF patients and then perform meta-analysis of these data.[Results] Etiological composition of maintenance hemodialysis patients including nephritis/nephrosis(60.25%),diabetes(13.41%),hypertension(9.76%),obstructive nephropathy by calculus(3.20%),polycystic kidney(1.92%) and Other reasons(8.92%).58.33% patients chose the Dialysis trail of Autogenous arteriovenous fistula,14.1% of patients chose long-term indwelling catheters.11.50% of patients chose temporary jugular vein cannulation.3.20% of patients chose temporary femoral vein cannulation.5.779% of patients chose temporary intubation but Ostomy.7.05% chose straight pricking.Long-term catheter infection:4 patients infected once,and accounted for 18.18% of the Long-term indwelling catheters,1 patient infected twice and accounted for 0.64%.Thrombotic complications of plugging were not found;One patient had vascular prosthesis,and he changed the long-term indwelling catheters due to the thrombus plug.The 1 year survival rate of dialysis was 10.9%.1 to 2 years survival rate was 33.97%.2 to 4 years survival rate was 25%.The 4 to 7 years survival rate was 21.16%.The 7 to 10 years survival rate was 7.05%.The 10 more years survival rate was 1.92.[Conclusion] The chronic glomerulonephritis,diabetic nephropathy,hypertension and obstructive nephropathy were the etiological composition of chronic renal failure in our Blood Purification Center.Hemodialysis mainly use Autogenous fistula.Temporary intubation was temporary transition,and long-term catheter has complications of infection and embolism.But this method is an ideal choice to move fistula,transplantation of blood vessel,transplantation artificial blood vessel or surgical failure.更多还原