尿毒症维持性血液透析动静脉内瘘患者发生皮下血肿的相关危险因素<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2025.06.005

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摘要【目的】探讨尿毒症维持性血液透析动静脉内瘘患者发生皮下血肿的相关危险因素。【方法】回顾性分析2018年7月至2023年12月本院收治的120例尿毒症维持性血液透析动静脉内瘘患者的临床资料,根据患者是否发生皮下血肿将其分为发生组(n=34)和未发生组(n=86)。收集患者临床资料,采用Logistic回归分析尿毒症维持性血液透析动静脉内瘘患者发生皮下血肿的相关危险因素。【结果】发生组患者年龄>65岁、穿刺次数≥3次、穿刺口感染、透析后压迫止血时间<30 min所占比例均高于未发生组,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,年龄>65岁、穿刺次数≥3次、穿刺口感染、透析后压迫止血时间<30 min均为尿毒症维持性血液透析动静脉内瘘患者发生皮下血肿的危险因素(P<0.05)。【结论】穿刺口感染、穿刺频率、止血压迫时间、年龄等均为影响尿毒症维持血液透析动静脉内瘘患者皮下发生血肿的相关因素,医护人员应加强穿刺口感染防控护理,适当减少穿刺频率,延长止血压迫时间,强化老年患者病情监测与症状评估。

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	高称称
	张明明
	刘军丽
	杜玉勤

关键词 ：尿毒症, 肾透析, 动静脉瘘, 血肿, 危险因素

Abstract：【Objective】To explore the related risk factors of subcutaneous hematoma in patients with arteriovenous fistula during uremic maintenance hemodialysis.【Methods】A retrospective analysis was conducted on the clinical data of 120 patients with arteriovenous fistula in uremic maintenance hemodialysis admitted to our hospital from July 2018 to December 2023. The patients were divided into the occurrence group (n=34) and the non-occurrence group (n=86) based on whether subcutaneous hematoma occurred. The clinical data of the patients were collected, and Logistic regression analysis was used to analyze the related risk factors of subcutaneous hematoma in patients with arteriovenous fistula during uremic maintenance hemodialysis.【Results】The proportions of age >65 years old, puncture times ≥3 times, puncture site infection, and compression hemostasis time <30 min after dialysis in the occurrence group were all higher than those in the non-occurrence group, and the differences were statistically significant (P<0.05). The results of Logistic regression analysis showed that age >65 years old, puncture times ≥3 times, puncture site infection, and compression hemostasis time <30 minutes after dialysis were all risk factors for subcutaneous hematoma in patients with arteriovenous fistula during uremic maintenance hemodialysis (P<0.05). 【Conclusion】Puncture site infection, puncture frequency, hemostasis compression time, age, etc. are all related factors affecting the subcutaneous hematoma of arteriovenous fistula in patients undergoing maintenance hemodialysis for uremia. Medical staff should strengthen the prevention and control nursing of puncture site infection, appropriately reduce the puncture frequency, prolong the hemostasis compression time, and enhance the condition monitoring and symptom assessment of elderly patients.

Key words： Uremia Renal Dialysis Arteriovenous Fistula Hematoma Risk Factors

收稿日期: 2024-06-15

中图分类号:

R692.5

基金资助:*河南省高等学校重点科研项目计划(18B310011)

引用本文:

高称称, 张明明, 刘军丽, 杜玉勤. 尿毒症维持性血液透析动静脉内瘘患者发生皮下血肿的相关危险因素^*[J]. 医学临床研究, 2025, 42(6): 927-929.
GAO Chengcheng, ZHANG Mingming, LIU Junli, et al. Related Risk Factors for Subcutaneous Hematoma in Patients with Arteriovenous Fistula during Uremic Maintenance Hemodialysis. JOURNAL OF CLINICAL RESEARCH, 2025, 42(6): 927-929.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.06.005 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I6/927

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