Influencing factors and countermeasures of blood purification adequacy in maintenance hemodialysis patients
维持性血液透析患者血液净化充分性的影响因素及对策

摘要

目的 分析在维持性血液透析（HD）患者治疗中采用不同血管通路对于血液透析净化效果及安全性的影响；方法 选取2023年1月至2024年12月该时段在我院接受HD治疗的60例患者，以对象匹配性原则分组，观察组与对照组各30例。对照组采用颈内静脉带隧道涤纶套导管（TCC）血管通路，观察组采用自体动静脉内瘘（AVF）血管通路，对两组的透析效果等指标进行比较；结果 观察组在透析治疗一个月后的尿素清除率（URR）、透析后尿素清除指数（Kt/V）均较高（P<0.05）。干预后，观察组的各项炎症指标水平及并发症发生率均较低（P<0.05）；结论 选用AVF来构建HD患者的血管通路，能够提升透析效果，促进血液净化充分性提高，且缓解炎症反应、改善预后，应用价值良好。

Abstract

Objective To analyze the influence of different vascular access on the purification effect and safety of maintenance hemodialysis (HD) patients.
Methods 60 patients who received HD treatment in our hospital from January 2023 to December 2024 were selected and divided into observation group and control group according to the principle of object matching, with 30 patients in each group. The control group used the internal jugular vein with tunnel dacron catheter (TCC) vascular access, while the observation group used the autologous arteriovenous fistula (AVF) vascular access, and compared the dialysis effect and other indicators between the two groups.
Results The urea clearance rate (URR) and urea clearance index (Kt/V) in the observation group were higher after one month of dialysis treatment (P<0.05). After the intervention, the levels of inflammatory indexes and the incidence of complications in the observation group were lower (P < 0.05).
Conclusion   Using AVF to construct vascular access of HD patients can improve the dialysis effect, promote the adequacy of blood purification, alleviate inflammatory reaction and improve prognosis, and has good application value.