丁浩, 危志强, 印荻, 蔡小琴, 李海涛, 曹娟, 章旭. 流入道血管钙化对终末期肾病患者动静脉内瘘的影响[J]. 临床肾脏病杂志, 2022, 22(3): 195-199. DOI: 10.3969/j.issn.1671-2390.2022.03.004
    引用本文: 丁浩, 危志强, 印荻, 蔡小琴, 李海涛, 曹娟, 章旭. 流入道血管钙化对终末期肾病患者动静脉内瘘的影响[J]. 临床肾脏病杂志, 2022, 22(3): 195-199. DOI: 10.3969/j.issn.1671-2390.2022.03.004
    Ding Hao, Wei Zhi-qiang, Yin Di, Cai Xiao-qin, Li Hai-tao, Cao Juan, Zhang Xu. Effect of inflow arterial calcification on arteriovenous fistula of end-stage renal disease patients[J]. Journal of Clinical Nephrology, 2022, 22(3): 195-199. DOI: 10.3969/j.issn.1671-2390.2022.03.004
    Citation: Ding Hao, Wei Zhi-qiang, Yin Di, Cai Xiao-qin, Li Hai-tao, Cao Juan, Zhang Xu. Effect of inflow arterial calcification on arteriovenous fistula of end-stage renal disease patients[J]. Journal of Clinical Nephrology, 2022, 22(3): 195-199. DOI: 10.3969/j.issn.1671-2390.2022.03.004

    流入道血管钙化对终末期肾病患者动静脉内瘘的影响

    Effect of inflow arterial calcification on arteriovenous fistula of end-stage renal disease patients

    • 摘要: 目的 探讨流入道血管钙化对终末期肾病患者动静脉内瘘成熟和血流量的影响。方法 选择2017年1月至2018年12月期间在蚌埠医学院附属泰兴市人民医院肾内科行内瘘手术的患者,收集临床资料,完善相关实验室检查后拟定手术方式。在术前行血管多普勒超声检查,分别检测头静脉、肱动脉、桡动脉的血管管径和血流量,同时评估动脉钙化情况,根据有无血管钙化将所有患者分为钙化组和非钙化组两组。动静脉内瘘术后第6及第12周行超声检查,比较2组患者内瘘成熟情况及血流量。结果 (1)共85例患者完成本次研究,钙化组38例,非钙化组47例,2组患者的年龄、性别、原发病、已行血透比例、吸烟史、相关血管的管径和血流量、手术方式差异均无统计学意义。(2)术后内瘘成熟率、超声检查成熟率、内瘘成熟时间、内瘘首次穿刺时间及再次手术率差异也均无统计学意义。(3)非钙化组患者术后第6周、第12周肱动脉血流量显著高于钙化组,而头静脉血流量、肱动脉及头静脉血管管径差异无统计学意义。(4)单因素Logistic回归分析显示,流入道血管钙化是术后肱动脉血流量低的独立危险因素(OR 2.314,95%CI:1.203~4.452,P=0.042)。结论 流入道血管钙化对动静脉内瘘成熟无明显不利影响,但血管钙化影响术后内瘘血流量,是血流量低的独立危险因素。

       

      Abstract: Objective To explore the effect of inflow arterial calcification on maturation and blood flow volume of arteriovenous fistula(AVF).Methods From January 2017 to December 2018,85 patients undergoing AVF creation were selected.Clinical data and laboratory parameters were recorded and then surgical approache sselected.Preoperative vascular Doppler ultrasonography was performed for detecting vascular diameter and blood flow volume of cephalic vein and brachial/radial artery.According to the status of vascular calcification,they were divided into two groups of calcified (n=38) and non-calcified (n=47).At Week 6/12 after AVF creation,ultrasonography was performed for comparing maturation and blood flow volume between two groups.Results No significant inter-group differences existed in age,gender,primary disease,hemodialysis ratio,smoking history,diameter and blood flow volume of related vessels or surgical approach.No significant differences existed in AVF maturation rate,ultrasonic maturation rate,time of maturation,time to first cannulation and postoperative reoperative rate.Flow volume of inflow arterial blood was significantly higher in non-calcified group at Week 6/12 post-operation.No significant differences existed in blood flow volume of cephalic vein or postoperative diameters of brachial artery and cephalic vein.Univariate Logistic regression analysis indicated that vascular calcification in inflow artery was an independent risk factor for low blood flow volume post-operation (OR2.314,95%CI:1.203~4.452,P=0.042).Conclusion Inflow arterial calcification do not adversely affect the status of AVF maturation,but affect blood flow volume post-operation.It is an independent risk factor for low blood flow volume.

       

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