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目的:探讨终末期肾衰血透患者自体动静脉内瘘血栓栓塞的原因。方法:回顾性分析26例终末期肾衰血透患者自体动静脉内瘘血栓栓塞组的性别、年龄、透析龄、有无合并糖尿病、透后平均动脉压、超滤剂量、有无高脂血症、有无抗凝治疗等,同期30例没有形成血栓的年龄性别相匹配的终末期肾衰血透患者作为对照。结果:血栓栓塞组较对照组透析龄相对时间较长(P<0.01),透后平均动脉压偏低(P<0.01),超滤剂量较多(P<0.01),高脂血症发生率较高(P<0.05)。多因素二元Logistic回归分析显示透后平均动脉压(RR0.522、P=0.023)、超滤剂量(RR7.405、P=0.035)是自体动静脉内瘘血透患者发生血栓栓塞的主要危险因素。结论:终末期肾衰血透患者透析龄延长、透后平均动脉压低、超滤剂量多、高脂血症易导致自体动静脉内瘘血栓栓塞。
Objective: To investigate the causes of thromboembolism of autogenous arteriovenous fistula in patients with end-stage renal failure. Methods: A retrospective analysis of 26 patients with end-stage renal failure hemodialysis patients with arteriovenous fistula thromboembolism gender, age, dialysis age, with or without diabetes, after the mean arterial pressure, ultrafiltration dose, with or without hyperlipidemia Symptoms, with or without anticoagulant therapy, the same period 30 cases did not form thrombosis age and sex matched end-stage renal failure patients as a control. Results: Compared with the control group, the duration of dialysis was longer in the thromboembolism group (P <0.01), the mean arterial pressure was lower (P <0.01), the amount of ultrafiltration was higher (P <0.01), and the incidence of hyperlipidemia Higher (P <0.05). Multivariate Logistic regression analysis showed that the mean arterial pressure (RR0.522, P = 0.023) and the ultrafiltration dose (RR7.405, P = 0.035) were the major risk factors for thromboembolism in patients with hemodialysis of arteriovenous fistula factor. CONCLUSION: The patients with end-stage renal failure have prolonged dialysis age, mean arterial pressure decrease, ultrafiltration dose, and hyperlipidemia, which lead to thromboembolism of autologous arteriovenous fistula.