血液透析患者长期血透导管拔管原因的回顾性分析

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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.

Key words： Hemodialysis Central vein catheter Long-term hemodialysis catheter Tunneled cuffed catheter

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	ZENG Yan
	CHEN You-ming

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ZENG Yan,CHEN You-ming. A retrospective analysis of the causes of long-term hemodialysis catheter extubation in hemodialysis patients[J]. 中国当代医药, 2020, 27(31): 200-204.

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2020/V27/I31/200

[1]	国家肾脏病医疗质量控制中心.全国血液净化病例信息登记系统[EB/OL].http：//www.cnrds.net/
[2]	中国医院协会血液净化中心分会血管通路工作组.中国血液透析用血管通路专家共识（第2版）[J].中国血液净化，2019，18（6）：365-381.
[3]	美国肾脏数据系统年度报表[EB/OL].https：//www.usrds.org/2018/view/v2-03.aspx
[4]	Wang K，Wang P，Liang X，et al.Epidemiology of haemodialysis catheter complications：a survey of 865 dialysis patients from 14 haemodialysis centres in Henan province in China[J].BMJ Open，2015，5（11）：e007136.
[5]	Adwaney A，Lim C，Blakey S，et al.Central venous stenosis，access outcome and survival in patients undergoing maintenance hemodialysis[J].Clin J Am Soc Nephrol，2019，14（3）：378-384.
[6]	Krishna P，Robert RQ，Alix C，et al.Complications from tunneled hemodialysis catheters：a Canadian observational cohort study[J].AJKD，2019，73（4）：467-475.
[7]	Murea M，James KM，Russell GB，et al.Risk of catheter-related bloodstream infection in elderly patients on hemodialysis[J].Clin J Am Soc Nephrol，2014，9（4）：764-770.
[8]	Canaud B，Tong L，Tentori F，et al.Clinical practices and outcomes in elderly hemodialysis patients：results from the Dialysis Outcomes and Practice Patterns Study（DOPPS）[J].Clin J Am Soc Nephrol，2011，6（7）：1651-1662.
[9]	Dufour A，Candas V.Ageing and thermal responses during passive heat exposure：sweating and sensory aspects[J].Eur J Appl Physiol，2007，100（1）：19-26.
[10]	Jean G，Charra B，Chazot C，et al.Risk factor analysis for long-term tunneled dialysis catheter-related bacteremias[J].Nephron，2002，91（3）：399-405.
[11]	Vander Sande FM，Kooman JP，Leunissen KM.The predictive value of C-reactive protein in end-stage renal disease：is it clinically significant?[J].Blood Purif，2006，24 （4）：335-341.
[12]	Perez GR，Rodriguez BP.Why and how to monitor bacterial contamination of dialysate?[J].Nephrol Dial Transplant，2000，15（6）：760-764.
[13]	Kuo WH，Lee YT，Ng HY，et al.C-reactive protein variability is associated with vascular access outcome in hemodialysis patients[J].J Clin Lab Anal，2017，32（1）：e22213.
[14]	Undas A，Plicner D，Stepien E，et al.Altered fibrin clot structure in patients with advanced coronary artery disease：a role of C-reactive protein，lipoprotein （a） and homocysteine[J].J Thromb Haemost，2007，5（9）：1988-1990.
[15]	Undas A，Stepien E，Tracz W，et al.Lipoprotein（a） as a modifier of fibrin clot permeability and susceptibility to lysis[J].J Thromb Haemost，2006，4（5）：973-975.
[16]	Undas A，Kolarz M，Kopec G，et al.Altered fibrin clot properties in patients on long-term haemodialysis：relation to cardiovascular mortality[J].Nephrol Dial Transplant，2008，23（6）：2010-2015.
[17]	Valdete TS，Haxhibeqiri V，Begolli L，et al.Correlation of inflammation and lipoprotein（a） with hypercoagulability in hemodialysis patients[J].Med Arch，2015，69（4）：232-235.