【摘要】 目的:了解血液透析患者的血管通路现状。方法:回顾性分析中南大学湘雅医院血液透析中心2015年4月1日至2016年4月1日新导入及维持性血液透析患者的基本资料、血管通路选择和并发症。结果:维持性血液透析患者258例,采用自体动静脉内瘘(artetiovenous fistula,AVF)的患者占87.60%、带涤纶套带隧道导管占12.40%。新导入患者61例,首次透析采用无隧道无涤纶套导管的患者占80.33%,AVF占8.19%,带涤纶套带隧道导管占9.84%,动静脉穿刺占1.64%。AVF选择吻合血管依次为腕桡动脉-头静脉(76.55%)、肱动脉-头静脉(11.06%)、前臂中段桡动脉-头静脉(7.08%)、肱动脉-肘正中静脉和肱动脉-贵要静脉(5.31%)。AVF发生并发症占总AVF透析人数的34.07%,其中动脉瘤占24.34%。结论:维持性血液透析患者绝大多数采用AVF,而新导入透析患者中使用无隧道无涤纶套导管者比例较大。更多还原

【Abstract】 Objective:To investigate the status of vascular access in hemodialysis patients in our center.Methods:The general information of hemodialysis patients and types and complications of vascular access at Xiangya Hospital of Central South University from April 2015 to April 2016,were retrospectively analyzed.Results:Among 258 prevalent patients,87.60% of them had arteriovenous fistula(AVF),while 12.40% showed tunneled cuffed catheter.Of the 61 incident patients,80.33% of them initiated dialysis with a non-tunneled and non-cuffed catheter,8.19% with an AVF,9.84% with a tunneled cuffed catheter,and 1.64% with needle puncture.The types of AVF access included 76.55% of wrist radiocephalic fistula,7.08% of mid-forearm cephalic fistula,11.06% of elbow brachiocephalic fistula,and 5.31% of antecubital fistula and transposed basilic fistula.Seventy-seven(34.07%) patients with AVF suffered complications and wherein aneurysms accounted for 24.34%.Conclusion:In maintenance hemodialysis patients,autologous AVF is the prevalent vascular access.In the beginners for dialysis,non-tunneled and non-cuffed catheter are their choice.Additional efforts and incentives may be necessary to improve vascular access during the initiation of hemodialysis.更多还原