老年医学与保健2011，Vol.17Issue(5)：274-277,281,5.DOI:10.3969/j.issn.1008-8296.2011-05-07
老年血透患者动静脉内瘘并发症监测及其影响因素分析
Arteriovenous fistula complications monitoring and its correlation factors analysis in elderly maintenance hemodialysis patients
匡鼎伟 1丁峰 1薛骏 1李铭新 1黄碧红 1陈靖 1陆福明 1郝传明 1顾勇1
作者信息
- 1. 200040,上海市,复旦大学附属华山医院肾脏科
- 折叠
摘要
Abstract
Objective To monitor the latent complications of well-functioning arteriovenous fistula (AVF) and to evaluate its major risk factors as well as hemodynamics parameters analysis in elderly maintenance hemodialysis (e-MHD) patients. Methods Forty-one e-MHD patients with well-functioning AVF were enrolled. Complications included stenosis and thrombosis as well as hemodynamics parameters were examined by high-resolution B-mode ultrasonograph. The clinical and biochemical characteristics were performed. The related data were analyzed between complication positive group and negative group. Results Latent complications in well-functioning AVF were detected in 39.02 % e-MHD patients. The differences of internal diameter (P=0.015), blood flow (P=0.015) of feeding radial artery, flow velocity of end diastolic phase (P=0.038) and resistance index (P=0.009) were significant between complication positive group and negative group. While the differences of systolic blood pressure (P=0.042), levels of serum pre-albumin (P=0.006), high-density lipoprotein cholesterol (HDL-c) (P=0.008) and serum phosphate (P=0.002) between two groups were apparent. In Logistic multiple regression analysis, higher serum phosphate level (P=0.017) were the risk factors for incidence of AVF complications, while lower pre-albumin (P=0.020) and lower HDL-c level (P=0.024) were the protective factors. Conclusions A considerable proportion of latent complications exists in e-MHD patients with well-functioning AVF. The atherosclerotic feeding radial artery may play a key role in incidence of AVF complications and access dysfunction. Management of hyperphosphatemia, improvement of malnutrition and dyslipidemia as well as better control of blood pressure were of significance to reduce incidence of access complications and to prolong AVF patency rates in e-MHD patients.关键词
老年/血液透析/动静脉内瘘/并发症Key words
Elderly/ Hemodialysis/ Arteriovenous fistula/ Complications分类
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匡鼎伟,丁峰,薛骏,李铭新,黄碧红,陈靖,陆福明,郝传明,顾勇..老年血透患者动静脉内瘘并发症监测及其影响因素分析[J].老年医学与保健,2011,17(5):274-277,281,5.
