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[1]王 博,孙桂江,于海波,等.96例维持性血液透析患者长期中心静脉导管生存及其影响因素分析[J].天津医科大学学报,2018,24(06):509-512.
 WANG Bo,SUN Gui-jiang YU Hai-bo,JIA Lan,et al.Survival and its influencing factors of central venous catheter in 96 patients with maintenance hemodialysis[J].Journal of Tianjin Medical University,2018,24(06):509-512.
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96例维持性血液透析患者长期中心静脉导管生存及其影响因素分析(PDF)
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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
24卷
期数:
2018年06期
页码:
509-512
栏目:
临床医学
出版日期:
2018-11-20

文章信息/Info

Title:
Survival and its influencing factors of central venous catheter in 96 patients with maintenance hemodialysis
作者:
王 博孙桂江于海波贾 岚姜埃利
(天津医科大学第二医院肾脏病血液净化科,天津 300211)
Author(s):
WANG Bo SUN Gui-jiang YU Hai-bo JIA Lan JIANG Ai-li
(Department of Kidney Disease and Blood Purification, The Second Hospital,Tianjin Medical University, Tianjin 300211, China)
关键词:
肾透析中心静脉导管插入生存分析危险因素
Keywords:
renal dialysis central vein catheterization survivalanalysis Risk factors
分类号:
R692.5
DOI:
-
文献标志码:
A
摘要:
目的:探讨维持性血液透析患者长期中心静脉导管(CVC)生存时间及其影响因素。方法:选取2012年1月-2013年12月于我院初次行颈内静脉长期导管置入术的96例患者,从数字化管理系统中获取患者CVC自建立之初至4年末的临床资料,采用Kaplan-Meier方法绘制患者CVC的生存曲线,并用COX模型进一步分析影响CVC的生存因素。结果:CVC1年生存率95.8%,2年生存率86.46%,3年生存率71.86%,4年生存率53.13 %;导管感染组、糖尿病组CVC生存率低,尿激酶间断封管是CVC生存的保护因素,差异具有统计学意义。糖尿病(HR:2.263;95%CI: 1.210-4.230)、导管感染(HR:2.040;95%CI: 1.056-3.942)、低白蛋白(HR:0.878;95%CI: 0.795-0.969)是CVC生存危险因素。结论:糖尿病、导管相关感染(CRI)、低白蛋白是降低CVC使用寿命的危险因素。
Abstract:
Objective: To explore the survival time and its risk factors for central venous catheter(CVC)of patients with maintenance hemodialysis. Methods: A cohort study regarding 96 cases that insertedCVCs in our center for the first time from January2012 to December 2013was retrospectively performed.The clinical data of these patients from the CVC created four years later was obtained from digital management system. Kaplan-Meier survival curves and Cox proportional hazard models were used to determine the service life and related factors. Results: The survival rates for 1,2,3,4years were 95.8%,86.46%,71.86% or 53.13%.The diabetes group, catheter infections group have lower CVC survival rate, rokinase intermittentlyinstead of heparin as a locking solutiongroup had higher CVC survival rate, the difference had statistically significance.The risk factors for CVCsurvival were diabetes (HR:2.263;95%CI:1.210-4.230),catheter infections(HR:2.040;95%CI: 1.056-3.942), and loweralbumin (HR:0.878;95%CI:0.795-0.969). Conclusion: Diabetes, CRI and lowerserum albumin may be the main risk factors for CVC survival.

参考文献/References:


[1] NKF-KDOQI Vascular Access Work Group. Clinical practice guidelines for vascular access[J]. Am J Kidney Dis, 2006, 48 (Suppl 1):S248
[2] Valliant A M, Chaudhry M K, Yevzlin A S, et al. Tunneled Dialysis Catheter Exchange with Fibrin Sheath Disruption is not Associated with Increased Rate of Bacteremia[J]. J Vasc Access, 2015, 16(1): 52
[3] Allon M,Brouwer-Maier D J,Abreo K A, et al. Recommended clinical trial end points for dialysis catheters[J]. Clin J Amer Soci Nephrol, 2018, 13(3):495
[4] 王博,姜埃利,王立华,等.中心静脉导管作为透析通路的使用情况及其影响因素[J].天津医药,2013,41(10):1002
[5] Hemmelgarn B R, Moist L M, Lok C E, et al. Prevention of dialysis catheter malfunction with recombinant tissue plasminogen activator[J]. N Engl J Med,2011,364(4):303
[6] 朱虹.长期中心静脉导管功能不良的影响因素及处理[D].大连:大连医科大学,2017
[7] 王博,王立华,张瑞宁,等.血液透析长期中心静脉导管留置功能不良的影响因素分析[J].临床荟萃,2013,28(11):1216
[8] Shi M, Cui T L,Ma L, et al. Catheter failure and mortality in hemodialysis patients with tunneled cuffed venous catheters in a single center[J]. Blood Purif, 2017,43(4):321
[9] 张晓娟,郭华,张沙丽. 经皮下隧道留置的带涤纶套血液透析用长期导管使用的影响因素分析[J]. 中国血液净化,2014,13(1):41
[10] 邱创业.颈内留置带涤纶套透析管功能不良发生率及其影响因素[D]. 广州:暨南大学,2016
[11] Chan M R. Hemodialysis central venous catheter dysfunction[J].Semin Dial,2008,21(6):516
[12] 刘雪彬,刘奕深,林钒,等. 带涤纶套中心静脉长期导管在MHD患者中的生存情况及其危险因素分析[J].临床医学工程,2017, 24(10):1465
[13] 杜渊,杜浩昌,李春庆,等. 带涤纶套中心静脉长期导管在血液透析患者中的生存状况及影响因素分析[J].中国现代医学杂志,2011, 21(27):3400

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备注/Memo

备注/Memo:
基金项目 国家自然科学基金资助项目 (81600591)
作者简介 王博(1986-),男,医师,硕士,研究方向:肾脏病血液净化治疗;通信作者:姜埃利,E-mail:aili_j@163.com。
更新日期/Last Update: 2018-11-30