摘要
目的 比较自体动静脉内瘘(AVF)和带隧道带涤纶套导管(TCC)通路维持性血液透析(MHD)对患者营养状况、炎症及心功能的影响。方法 选取2021年3月—2022年3月阜阳市第二人民医院收治的92例MHD患者为研究对象,随机数字表法分为AVF组和TCC组,各46例,分别经AVF、TCC通路进行MHD治疗。比较二组MHD治疗12个月后透析质量[透析血流量、尿素清除率(Kt/V)、再循环率]、营养状况[血红蛋白(Hb)、血清白蛋白(Alb)、总蛋白(TP)]、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)]、心功能(左室肥厚、左室收缩功能障碍、左室舒张功能障碍)及MHD并发症发生情况。结果 AVF组的透析血流量、Kt/V、再循环率均明显高于TCC组(P<0.05)。AVF组外周血中Hb、Alb、TP水平均明显高于TCC组(P<0.05)。AVF组血清CRP、IL-6水平均明显低于TCC组(P<0.05)。AVF组左室肥厚占比明显高于TCC组(P<0.05);AVF组左室收缩功能障碍、左室舒张功能障碍占比虽高于TCC组,但组间比较差异无统计学意义(P>0.05)。AVF组MHD并发症总发生率明显低于TCC组(15.22%vs.34.78%,P<0.05)。结论 AVF通路的透析效果优于TCC通路,且AVF通路患者的营养状况更好,炎症水平更轻,MHD并发症发生率更低,但AVF通路较TCC通路更易引起左室功能异常。
Objective To compare the effects of autologous arteriovenous fistula(AVF)and tunneled cuffed catheter(TCC)pathway on maintenance hemodialysis(MHD)patients.Methods Ninety-two MHD patients admitted to Fuyang Second People's Hospital from March 2020 to February 2021 were selected as research objects and randomly divided into AVF group and TCC group(46 cases in each group)according to random number method.MHD treatment was performed through AVF and TCC pathways,respectively.The dialysis quality[dialysis blood flow,urea clearance rate(Kt/V),recycling rate],nutritional status[hemoglobin(Hb),serum albumin(Alb),total protein(TP)],inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)],cardiac function(left ventricular hypertrophy,left ventricular systolic dysfunction,left ventricular diastolic dysfunction)and MHD complications were compared between the two groups after 12 months of MHD treatment.Results The dialysis blood flow,Kt/V and recycling rate in AVF group were significantly higher than those in TCC group(P<0.05).The levels of Hb,Alb and TP in peripheral blood of AVF group were significantly higher than those of TCC group(P<0.05).Serum CRP and IL-6 levels in AVF group were significantly lower than that in TCC group(P<0.05).The proportion of left ventricular hypertrophy in AVF group was significantly higher than that in TCC group(P<0.05).The proportion of left ventricular systolic dysfunction and left ventricular diastolic dysfunction in AVF group was higher than that in TCC group,but there was no significant difference between the two groups(P>0.05).The total incidence of MHD complications in AVF group was significantly lower than that in TCC group(15.22%vs.34.78%,P<0.05).Conclusion The dialysis effect of AVF pathway is better than that of TCC pathway,and patients with AVF pathway have better nutritional status,lighter inflammation and lower incidence of MHD complications.However,AVF pathway is more likely to cause left ventricular dysfunction than TCC pathway.
作者
王瑞雪
张磊
王心亮
WANG Ruixue;ZHANG Lei;WANG Xinliang(Blood purification center of Fuyang Second People's Hospital,Fuyang 236000,China)
出处
《中国煤炭工业医学杂志》
2024年第1期52-56,共5页
Chinese Journal of Coal Industry Medicine
基金
安徽省自然科学基金项目(编号:19MH180923)。
关键词
自体动静脉内瘘
带隧道带涤纶套导管
血管通路
维持性血液透析
Autologous arteriovenous fistula
Tunnel with polyester sleeve
Vascular pathway
Maintenance hemodialysis
