自体动静脉内瘘血栓形成的影响因素

目的：了解动静脉内瘘血栓形成的原因，提出防治措施。方法：81例维持性血液透析患有15例内瘘发生血栓形成。分析病因、性别、年龄、血压、血脂对血栓形成的影响。结果：在内瘘使用的早期(三年内)易发生血栓，内瘘血栓发生率为18．52％。老年、男性、糖尿病、血压低、血脂高的患内瘘易发生血栓．结论：定时监测血管通路，适量使用促红索，缓慢提高血红蛋白，恰当地应用抗凝治疗；减慢透析超滤速度，防止透后低血压；采取阶梯式穿刺法，透析后采取点状压迫，防止力量过大，压迫时问过长和对患及家属进行保护内瘘的宣教均是预防内瘘发生血栓的重要措施。

Study on Native Arteriovenous Fistula Thrombus and its Correlated Risk Factors

Objective To investigate the fistula thrombus reasons in order to improve its prevention and treatment.Methods:Fifteen patients of 81 maintenance hemodialysis patients suffered from vascular fistula obstruction..Pathogenesis,age,blood pressure and serum lipids were analyzed.Results:Fistula thrombus occurred at the early stage of the maturation(between three years).The incindence of thrombus was 18.52%.The fistula of the patients with diabetes or older,male,hypotension after dialysis and higher serum lipids suffered from thrombus easily.Conclusion:Checked the fistula regularly,increase Hemoglobin slowly with EPO and anti-coagulate properly,reducing speed of ultrafiltration in order to prevent blood pressure dropping are effective.To puncture by step,press with a proper power at one point after dialysis and educate the patients and their relatives on how to protect fistula are also very important.