CAJ | 학술논문

目的：研究使用髂外静脉长期导管的老年维持性血液透析患者的生存情况。方法选取本院血液净化科2010-2011年期间收治的留置髂外静脉长期导管的老年维持性血液透析治疗患者70例为观察组，选取同期收治的留置颈内静脉长期导管的老年患者93例为对照组。检测患者血生化等临床指标，观察导管功能及相关并发症。结果髂外静脉组患者生存率及导管技术存活率均低于颈内静脉组（χ2=13.714，P＜0.01；χ2=13.093，P＜0.01）；髂外静脉组患者发生导管相关性感染的发生率低于颈内静脉组（χ2=9.416，P＜0.01）；心血管疾病（CVD）事件及导管功能不良的发生率高于颈内静脉组患者（χ2=7.492，P＜0.01；χ2=5.912，P＜0.05）。多因素Cox回归分析结果显示，心血管疾病事件和导管功能不良是留置髂外静脉长期导管的老年维持性血液透析患者死亡事件的危险因素。结论使用髂外静脉长期导管的老年血液透析患者生存率相对较低，发生导管功能不良、心血管疾病事件的风险增加。
목적：연구사용가외정맥장기도관적노년유지성혈액투석환자적생존정황。방법선취본원혈액정화과2010-2011년기간수치적류치가외정맥장기도관적노년유지성혈액투석치료환자70례위관찰조，선취동기수치적류치경내정맥장기도관적노년환자93례위대조조。검측환자혈생화등림상지표，관찰도관공능급상관병발증。결과가외정맥조환자생존솔급도관기술존활솔균저우경내정맥조（χ2=13.714，P＜0.01；χ2=13.093，P＜0.01）；가외정맥조환자발생도관상관성감염적발생솔저우경내정맥조（χ2=9.416，P＜0.01）；심혈관질병（CVD）사건급도관공능불량적발생솔고우경내정맥조환자（χ2=7.492，P＜0.01；χ2=5.912，P＜0.05）。다인소Cox회귀분석결과현시，심혈관질병사건화도관공능불량시류치가외정맥장기도관적노년유지성혈액투석환자사망사건적위험인소。결론사용가외정맥장기도관적노년혈액투석환자생존솔상대교저，발생도관공능불량、심혈관질병사건적풍험증가。
Objective To investigate the survival of older patients with iliac vein tunneled cuffed catheters on maintenance hemodialysis. Methods A total of 70 older patients with external iliac vein tunneled cuffed catheters on maintenace hemodialysis were included in this study, there were 94 patients with internal jugular vein tunneled cuffed catheters as control group. The baseline anthropometric and 1aboratory parameters were measured. The catheter dysfunction and catheter related complications were documented. Results There were lower survival rate and catheter survival in the external iliac vein group compared with internal jugular vein group(χ2=13.714, P<0.01; χ2=13.093, P<0.01). Compared with internal jugular vein group, there was lower rate of catheter infection in external iliac vein group(χ2=9.416, P<0.01); In addition, there were higher rate of cardiovascular disease(CVD) events and catheter dysfunction among patients in external iliac vein group (χ2=7.492, P<0.01; χ2=5.912, P<0.05). Furthermore, the incidence of catheter dysfunction and cardiovascular disease events were the independent risk factors of mortality for older patients with iliac vein tunneled cuffed catheters on maintenance hemodialysis by Cox regression model. Conclusions Patients with iliac vein tunneled cuffed catheters have a shorter survival time. Those with catheter dysfunction or cardiovascular disease events are in higher risk of mortality.