安惠旒, 王世杰. 自体动静脉瘘与深静脉导管长期留置对MHD病人透析效果及心功能、肾性贫血的影响[J]. 蚌埠医学院学报, 2021, 46(1): 39-43. DOI: 10.13898/j.cnki.issn.1000-2200.2021.01.011
    引用本文: 安惠旒, 王世杰. 自体动静脉瘘与深静脉导管长期留置对MHD病人透析效果及心功能、肾性贫血的影响[J]. 蚌埠医学院学报, 2021, 46(1): 39-43. DOI: 10.13898/j.cnki.issn.1000-2200.2021.01.011
    AN Hui-liu, WANG Shi-jie. Effect of autologous arteriovenous fistula and long-term indwelling of deep venous catheter on the hemodialysis, cardiac function and renal anemia in MHD patients[J]. Journal of Bengbu Medical College, 2021, 46(1): 39-43. DOI: 10.13898/j.cnki.issn.1000-2200.2021.01.011
    Citation: AN Hui-liu, WANG Shi-jie. Effect of autologous arteriovenous fistula and long-term indwelling of deep venous catheter on the hemodialysis, cardiac function and renal anemia in MHD patients[J]. Journal of Bengbu Medical College, 2021, 46(1): 39-43. DOI: 10.13898/j.cnki.issn.1000-2200.2021.01.011

    自体动静脉瘘与深静脉导管长期留置对MHD病人透析效果及心功能、肾性贫血的影响

    Effect of autologous arteriovenous fistula and long-term indwelling of deep venous catheter on the hemodialysis, cardiac function and renal anemia in MHD patients

    • 摘要:
      目的研究自体动静脉瘘与深静脉导管长期留置对维持性血液透析(MHD)病人透析效果及心功能、肾性贫血的影响。
      方法选取MHD病人120例作为研究对象,随机分为观察组和对照组,各60例。观察组病人采取自体动静脉瘘进行MHD,对照组病人采取深静脉导管长期留置治疗。比较2组病人的治疗效果、透析充分性、心功能、肾功能、炎性反应、并发症发生情况。
      结果观察组病人总有效率为83.33%,明显高于对照组的66.67%(P < 0.01)。观察组病人的血液透析充分性为(1.68±0.36)g/kg,明显高于对照组的(1.26±0.21)g/kg(P < 0.01)。2组病人治疗前血红蛋白、肾小球滤过率和左心室射血分数(LVEF)、左心房前后直径(LAD)、右心室内径(RVD)、左心室内径(LVD)、左心室舒张末期容积(LVEDV)及炎性因子水平差异均无统计学意义(P>0.05)。治疗后,观察组血红蛋白和肾小球滤过率均明显高于对照组(P < 0.01);2组病人LVEDV、LAD均较治疗前明显提高(P < 0.05~P < 0.01),LVEF均明显下降(P < 0.01),且观察组LVEF明显高于对照组(P < 0.01),LAD、RVD、LVEDV均明显低于对照组(P < 0.01);2组肿瘤坏死因子α、白细胞介素6、白细胞介素8水平均较治疗前明显降低(P < 0.01),且观察组均明显低于对照组(P < 0.01)。2组病人感染和肾性贫血发生差异均无统计学意义(P>0.05),观察组病人发生心血管事件低于对照组(P < 0.05)。
      结论相较于深静脉导管长期留置,自体动静脉瘘对MHD病人透析效果更好,且对病人心功能影响较小,建议临床推广。

       

      Abstract:
      ObjectiveTo study the effects of autologous arteriovenous fistula and long-term indwelling of deep venous catheter on the hemodialysis, cardiac function and renal anemia in maintenance hemodialysis(MHD)patients.
      MethodsOne hundred and twenty patients with MHD were randomly divided into the observation group and control group(60 cases in each group).The observation group was treated with autologous arteriovenous fistula for MHD, while the control group was treated with long-term indwelling of deep venous catheter.The therapeutic effects, dialysis adequacy, cardiac function, renal function, inflammatory reaction and complications were compared between two groups.
      ResultsThe total effective rate in observation group(83.33%)was significantly higher than that in control group(66.67%)(P < 0.01), and the hemodialysis adequacy in observation group(1.68±0.36)g/kg was significantly higher than that in control group(1.26±0.21)g/kg(P < 0.01).The differences of the hemoglobin, glomerular filtration rate, left ventricular ejection fraction(LVEF), anterior and posterior left atrial diameter(LAD), right ventricular inner diameter(RVD), left ventricular end-diastolic volume(LVEDV), and inflammatory factor levels between two groups before treatment were not statistically significant(P>0.05).After treatment, the hemoglobin and glomerular filtration rate in observation group were significantly higher than those in control group(P < 0.01).Compared with before treatment, the levels of LAD and LVEDV significantly increased, and the LVEF level significantly decreased in two groups after treatment(P < 0.05 to P < 0.01).After treatment, the level of LVEF in observation group was higher than that in control group, while the levels of LAD, RVD and LVEDV in observation group were lower than those in control group (P < 0.01).After treatment, the levels of TNF-α, IL-6 and IL-8 in two groups significantly decreased compared with before treatment(P < 0.01), and the above parameters in observation group were significantly lower than those in control group(P < 0.01).The differences of the incidence rates of infection and renal anemia between two groups were not statistically significant(P>0.05), and the cardiovascular events in observation group was significantly lower than that in control group(P < 0.05).
      ConclusionsCompared with the long-term indwelling of deep venous catheter, the effects of autologous arteriovenous fistula on dialysis in MHD patients is better, wich has less impact on cardiac function, and is worthy of promotion in clinic.

       

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