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血管通路问卷:英国单中心经验。

The vascular access questionnaire: a single centre UK experience.

机构信息

Department of Renal Transplantation and Vascular Access Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, B15 2TH, UK.

Institute of Translational Medicine, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.

出版信息

BMC Nephrol. 2019 Aug 5;20(1):299. doi: 10.1186/s12882-019-1493-9.

Abstract

BACKGROUND

Haemodialysis is capable of prolonging life in patients with end stage renal disease, however this therapy comes with significant negative impact on quality of life. For patients requiring haemodialysis, the need for an adequately functioning vascular access (VA) is an everyday concern. The Vascular Access Questionnaire (VAQ) provides a mechanism for identifying and scoring factors in haemodialysis that impact on patients' quality of life and perception of their therapy.

METHODS

Between April 2017-18 the VAQ was administered to prevalent haemodialysis patients at 10 units in the West Midlands via structured interviews.

RESULTS

749 of 920 potentially eligible patients completed the survey. The mean VAQ score was seen to improve significantly with age (7.7 in < 55 vs. 3.8 in 75+) and the duration of access (8.9 if less than 1 month old vs. 5.0 at a year). Better average scores were demonstrated for Arteriovenous fistulas (AVF) than other modalities (AVF 5.1 vs. AVG (arteriovenous grafts) 7.2 vs. CVC (central venous catheter) 6.6). There was no significant difference in scores between fistulas on non-dominant or dominant arms, with both having a mean of 5.2 (p = 0.341).

CONCLUSIONS

Overall, better satisfaction scores were seen in AVF. The presence of an AVF on the non-dominant arm was not a concern for the majority of patients and did not affect the VAQ score. A number of factors were identified that can influence VAQ satisfaction score.

摘要

背景

血液透析能够延长终末期肾病患者的生命,但会对生活质量产生重大负面影响。对于需要血液透析的患者而言,需要有一个功能正常的血管通路(VA),这是他们每天都要关心的问题。血管通路问卷(VAQ)提供了一种识别和评分血液透析中对患者生活质量和治疗感知产生影响的因素的方法。

方法

2017 年 4 月至 2018 年期间,通过结构访谈,在西米德兰兹地区的 10 个单位对现有的血液透析患者进行了 VAQ 调查。

结果

在 920 名符合条件的患者中,有 749 名完成了调查。VAQ 评分随年龄的增长而显著改善(<55 岁的患者为 7.7,75+岁的患者为 3.8),且随通路使用时间的延长而改善(<1 个月的患者为 8.9,1 年的患者为 5.0)。动静脉瘘(AVF)的平均评分明显优于其他类型的通路(AVF 为 5.1,AVG 为 7.2,CVC 为 6.6)。非优势手臂和优势手臂上的瘘管评分没有显著差异,两者的平均评分均为 5.2(p=0.341)。

结论

总体而言,AVF 的满意度评分更高。大多数患者对非优势手臂上的 AVF 并不担心,也不会影响 VAQ 评分。确定了一些会影响 VAQ 满意度评分的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b17/6683579/4363b1e5b53d/12882_2019_1493_Fig1_HTML.jpg

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