摘要
目的:观察肱动脉-肘正中静脉自体动静脉内瘘(AVF)在维持性血液透析患者中的应用效果。方法:回顾性分析2021年10月至2022年10月该院收治的70例维持性血液透析患者的临床资料,按AVF术式不同分为观察组和对照组各35例。对照组采用头静脉-桡动脉AVF治疗,观察组采用肱动脉-肘正中静脉AVF治疗,比较两组一次性手术成功率、术后6个月内瘘通畅率、术后1年内瘘通畅率、血清炎性因子[白细胞介素(IL)-6、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]水平、肾脏疾病特异性调查表(KDQ)评分和并发症发生率。结果:观察组一次性手术成功率为100.00%,高于对照组的82.86%,差异有统计学意义(P<0.05);观察组术后6个月内瘘通畅率为97.14%,高于对照组的71.43%,差异有统计学意义(P<0.05);观察组术后1年内瘘通畅率为94.29%,高于对照组的57.14%,差异有统计学意义(P<0.05);术后6个月,两组KDQ评分高于术前,且观察组高于对照组,差异均有统计学意义(P<0.05);术后,两组血清IL-6、hs-CRP、TNF-α等炎性因子水平和并发症发生率比较,差异均无统计学意义(P>0.05)。结论:肱动脉-肘正中静脉AVF用于维持性血液透析患者可提高一次性手术成功率、术后6个月内瘘通畅率、术后1年内瘘通畅率、术后6个月KDQ评分,效果优于头静脉-桡动脉AVF治疗。
Objective:To observe application effects of brachial artery-median cubital vein autogenous arteriovenous fistula(AVF)surgery in patients with maintenance hemodialysis.Methods:The clinical data of 70 patients with maintenance hemodialysis admitted to this hospital from October 2021 to October 2022 were retrospectively analyzed.According to different AVF surgery methods,they were divided into observation group and control group,35 cases in each group.The control group was treated with cephalic vein-radial artery AVF surgery,while the observation group was treated with brachial artery-median cubital vein AVF surgery.The success rate of one-time surgery,the internal fistula patency rate 6 months after the surgery,the internal fistula patency rate within 1 year after the surgery,the serum inflammatory factors[interleukin(IL)-6,high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)]levels,the kidney disease-specific questionnaire(KDQ)score,and the incidence of complications were compared between the two groups.Results:The success rate of one-time surgery in the observation group was 100.00%,which was higher than 82.86%in the control group,and the difference was statistically significant(P<0.05).The internal fistula patency rate 6 months after the surgery in the observation group was 97.14%,which was higher than 71.43%in the control group,and the difference was statistically significant(P<0.05).The internal fistula patency rate within 1 year after the surgery in the observation group was 94.29%,which was higher than 57.14%in the control group,and the difference was statistically significant(P<0.05).6 months after the surgery,the KDQ scores of the two groups were higher than those before the surgery,that in the observation group was higher than that in the control group,and the differences were statistically significant(P<0.05).After the surgery,there were no significant differences in the levels of serum IL-6,hs-CRP,TNF-αand other inflammatory factors and the incidence of complications between the two groups(P>0.05).Conclusions:Brachial artery-median cubital vein AVF surgery for the maintenance hemodialysis patients can improve the success rate of one-time surgery,the internal fistula patency rate 6 months after surgery,the internal fistula patency rate within 1 year after surgery,and the KDQ scores 6 months after surgery.Moreover,it is superior to cephalic vein-radial artery AVF surgery.
作者
焦林娟
陈庆云
王莹
刘萍
JIAO Linjuan;CHEN Qingyun;WANG Ying;LIU Ping(Department of Nephrology of Nanyang Second General Hospital,Nanyang 473000 Henan,China)
出处
《中国民康医学》
2025年第20期50-52,共3页
Medical Journal of Chinese People’s Health
关键词
肱动脉-肘正中静脉
头静脉-桡动脉
自体动静脉内瘘术
维持性血液透析
内瘘通畅率
Brachial artery-median cubital vein
Cephalic vein-radial artery
Autologous arteriovenous fistula surgery
Maintenance hemodialysis
Internal fistula patency rate
