Department of Nephrology, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Nephrology, Huangshi Central Hospital of Hubei Polytechnic University, Huangshi, China.
J Vasc Access. 2021 Mar;22(2):280-287. doi: 10.1177/1129729820937484. Epub 2020 Jul 4.
Coronavirus disease 2019 is an epidemic disease throughout the world. The management of vascular access during the epidemic is currently unknown.
In this multicenter cross-sectional study, we collected vascular access data from hemodialysis patients treated at 44 hospitals in Hubei from 22 January to 10 March 2020. We estimated the management of vascular access during the coronavirus disease 2019 outbreak.
Of the 9231 hemodialysis patients included, 5387 patients (58.4%) were men and 2959 patients (32.1%) were older than 65 years. Arteriovenous fistula was the predominant type of vascular access, accounting for 76.5%; 496 patients (5.4%) developed vascular access complications; catheter flow reduction was the most common vascular access complication, and stenosis was the predominant complication among those with arteriovenous access. Overall, 280 vascular access sites were placed in patients newly diagnosed with uremia, of whom 260 (92.8%) underwent catheter insertion; 149 rescue procedures were carried out to treat the vascular access complications, which consisted of 132 catheters, 7 percutaneous transluminal angioplasties, 6 arteriovenous fistula repairs, and 4 arteriovenous fistulas. Occlusion of the arteriovenous access had the highest rescue rate (92.7%), while many other vascular access complications remained untreated; 69 and 142 patients were diagnosed with confirmed and suspected coronavirus disease 2019, respectively. A total of 146 patients died, of whom 29 patients (19.9%) died due to vascular access complications.
Catheter flow reduction and stenosis of arteriovenous access were the major vascular access complications. Most of the vascular access sites established were catheters, and many of the vascular access complications remained untreated.
2019 年冠状病毒病是一种全球性传染病。目前尚不清楚在流行期间血管通路的管理方法。
在这项多中心横断面研究中，我们收集了 2020 年 1 月 22 日至 3 月 10 日期间在湖北省 44 家医院接受治疗的 9231 例血液透析患者的血管通路数据。我们估计了 2019 年冠状病毒病流行期间血管通路的管理方法。
在纳入的 9231 例血液透析患者中，5387 例（58.4%）为男性，2959 例（32.1%）年龄大于 65 岁。动静脉瘘是最主要的血管通路类型，占 76.5%；496 例（5.4%）发生血管通路并发症；导管血流减少是最常见的血管通路并发症，而狭窄是动静脉通路并发症的主要类型。总体而言，280 例新诊断为尿毒症的患者进行了血管通路置管，其中 260 例（92.8%）进行了导管插入术；为治疗血管通路并发症进行了 149 次抢救手术，包括 132 个导管、7 个经皮腔内血管成形术、6 个动静脉瘘修复术和 4 个动静脉瘘。动静脉通路闭塞的抢救成功率最高（92.7%），而许多其他血管通路并发症仍未得到治疗；确诊和疑似 2019 冠状病毒病患者分别为 69 例和 142 例。共有 146 例患者死亡，其中 29 例（19.9%）因血管通路并发症死亡。
导管血流减少和动静脉通路狭窄是主要的血管通路并发症。建立的大多数血管通路部位都是导管，许多血管通路并发症仍未得到治疗。
