Abstract：Objective To explore the causes of long-term hemodialysis catheter extubation in hemodialysis patients.Methods A retrospective analysis of 66 patients with long-term hemodialysis catheters removed due to catheter loss(hereinafter referred to as "loss of function") in Fujian Provincial Hospital from August 2013 to August 2018.The system sampling method was adopted to obtain 66 patients with normal catheter function for the control group.The general data and laboratory data of the two groups were collected as observation items.The observation items were analyzed by the statistical method to sum up the relevant risk factors of the extubation.Results There were 419 cases who met entry criteria and the rate of out-of-work extubation was 15.75%.The main causes of the out-of-work were that the function of the catheter was not good,the infection of the catheter and the withdrawal of the catheter,and the rates were 48.48%,24.24% and 21.21% respectively.The results of univariate analysis showed that there were statistically significant differences in age,blood flow,thrombotic history,serum albumin,total cholesterol,lipoprotein a,carbon dioxide binding capacity,and C-reactive protein between the failure extubation group and the control group (P＜0.05).The results of multivariate analysis suggested that age (β=0.053,OR=1.062,95%CI=1.007-1.120),C-reactive protein (β=0.057,OR=1.054,95%CI=1.011-1.098),blood flow (β=-0.034,OR=0.968,95%CI=0.944-0.993),lipoprotein a (β=0.003,OR=1.003,95%CI=1.000-1.565) were related factors (P＜0.05).Among them,the OR of age and CRP were greater than 1,and the OR of blood flow was less than 1,for catheter failure,advanced age,high CRP，and low blood flow were considered as the independent risk factors; the OR of lipoprotein a was greater than 1,but the 95% confidence interval included 1,so high lipoprotein a was considerd as an independent risk factor.Conclusion Advanced age and high CRP are independent risk factors for long-term catheter failure,and blood flow is an important reference factor,and lipoprotein a has an important significance for further study.Among them,the significance of C-reactive protein is the most clear,and it is necessary to carry out long-term continuous monitoring.
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