摘要
目的分析影响中青年终末期肾病患者血液透析内瘘功能不良的发生情况及危险因素,并制定针对性的应对策略。方法回顾性收集2020年2月至2023年2月于上海交通大学医学院附属仁济医院进行血液透析治疗的400例中青年终末期肾病患者的临床资料,记录内瘘功能不良的发生情况,并采用多因素Logistic回归分析内瘘功能不良发生的影响因素。结果400例中青年终末期肾病患者中,112例发生内瘘功能不良,发生率为28.00%。多因素Logistic回归分析结果显示,原发疾病为糖尿病肾病、吻合口直径小、肱动脉流量小、高血钙、高血磷,以及高水平的总胆固醇(TG)、D-二聚体(D-D)和糖化血红蛋白(GHB)均是内瘘功能不良的独立危险因素(P均<0.05)。结论中青年终末期肾病患者血液透析内瘘功能不良发生率仍然居高不下,主要与原发疾病、吻合口直径、肱动脉流量、血钙、血磷、TG、D-D及GHB水平等有关,应及时予以针对性应对策略干预,从而降低内瘘功能不良的发生率。
Objective To analyze the incidence and risk factors of dysfunction of hemodialysis internal fistula in young and middle-aged patients with end-stage renal disease,and to develop targeted countermeasures.Methods Retrospective collection of clinical data was conducted from 400 young and middle-aged patients with end-stage renal disease who underwent hemodialysis at Renji Hospital,Shanghai Jiao Tong University School of Medicine between February 2020 and February 2023.The incidence of internal fistula dysfunction was recorded,and multivariate logistic regression analysis was used to analyze the influencing factors of internal fistula dysfunction.Results Among the 400 young and middle-aged patients with end-stage renal disease,112(28.00%)exhibited internal fistula dysfunction.Multivariate logistic regression analysis showed that diabetic nephropathy as the primary disease,small-diameter anastomotic stoma,low-flow brachial artery,hypercalcemia,hyperphosphatemia,high levels of total cholesterol(TG),D-dimer(D-D)and glycosylated hemoglobin(GHB)were the independent risk factors for internal fistula dysfunction(P<0.05).Conclusion The incidence of hemodialysis internal fistula dysfunction in young and middle-aged patients with end-stage renal disease remains high,mainly related to the primary disease,anastomotic diameter,brachial artery flow,blood calcium,blood phosphorus,TG,D-D,and GHB levels.Targeted countermeasures should be implemented in a timely manner to reduce the incidence of internal fistula dysfunction.
作者
黄云娟
金艳
顾夏青
吴芳芳
HUANG Yunjuan;JIN Yan;GU Xiaqing;WU Fangfang(Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200120,China)
出处
《中西医结合护理(中英文)》
2025年第2期169-172,共4页
Journal of Clinical Nursing in Practice
关键词
终末期肾病
中青年
血液透析
内瘘功能不良
影响因素
end-stage renal disease
young and middle-aged people
hemodialysis
internal fistula dysfunction
influencing factor
