Wang Ruimin, Wang Siyan, Xue Xiaoling, Yue Xiaohong, Wang Xinfang, Wang Pei, Liang Xianhui
（ 450052） Blood Purification Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2024 Jul 20;55(4):1001-1006. doi: 10.12182/20240760207.
To evaluate the effects of the multiple single cannulation technique (MUST) on the outcomes of arteriovenous graft (AVG).
A retrospective study of AVG created between January 2018 and December 2021 at the First Affiliated Hospital of Zhengzhou University was conducted. The clinical data of patients and their follow-up data for venous access were analyzed. Subjects were divided into the MUST group or the non-MUST group according to whether MUST was used. The cumulative patency rate and complication incidence were compared between the two groups. Logistic regression was applied to analyze the influencing factors of applying MUST in AVG.
The MUST group included 115 AVG and the non-MUST group, 122 AVG. The 1-year, 2-year, 3-year, and 4-year cumulative patency rates of the MUST group were 100%, 99.1%, 95.2%, 85.4%, and 73.2%, respectively, while those for the non-MUST group were 97.5%, 92.7%, 77.7%, 69.7%, and 50.0%, respectively, with the 2-year and 3-year patency rates showing significant difference (=0.022, =0.004). The standard intervention rate expressed in (median [interquartile range]) in the MUST group was significantly lower than that in the non-MUST group (0.46 [0.00, 0.94] vs. 0.97 [0.60, 1.59], =-5.808, <0.001). A total of 24 (20.9%) AVG in the MUST group and 60 (49.2%) AVG in the non-MUST group had a standard intervention rate >1.0 per patient-year, with significant difference between the two groups. Three (2.6%) AVG in the MUST group and 7 (5.7%) AVG in the non-MUST group were complicated by aneurysm ( =20.737, P<0.001). One (0.9%) AVG in the MUST group and 6 (4.9%) AVG in the non-MUST group had graft infection, with the difference between the groups showing no significance (=0.121). Multivariate logistic regression showed that dialysis in the alliance facilities (odds ratio [OR]=2.713, 95% confidence interval [CI]: 1.698-4.336, <0.001], and excellent follow-up [OR=2.189, 95% CI: 1.221-3.927, =0.009] were the influencing factors of applying MUST in AVG.
MUST improves the cumulative patency of AVG and decreases the intervention frequency and the incidence of aneurysm without increasing the risk of graft infection.
评估多根单通道插管技术（MUST）对动静脉移植物（AVG）使用效果的影响。
对2018年1月至2021年12月在郑州大学第一附属医院建立的AVG进行回顾性研究。分析患者的临床资料及其静脉通路的随访数据。根据是否使用MUST将研究对象分为MUST组和非MUST组。比较两组的累积通畅率和并发症发生率。应用Logistic回归分析AVG中应用MUST的影响因素。
MUST组有115例AVG，非MUST组有122例AVG。MUST组1年、2年、3年和4年的累积通畅率分别为100%、99.1%、95.2%、85.4%和73.2%，而非MUST组分别为97.5%、92.7%、77.7%、69.7%和50.0%，2年和3年的通畅率差异有统计学意义（P=0.022，P=0.004）。MUST组以（中位数[四分位间距]）表示的标准干预率显著低于非MUST组（0.46[0.00，0.94]对0.97[0.60，1.59]，P=-5.808，P<0.001）。MUST组共有24例（20.9%）AVG和非MUST组60例（49.2%）AVG的标准干预率>1.0/患者年，两组间差异有统计学意义。MUST组3例（2.6%）AVG和非MUST组7例（5.7%）AVG发生动脉瘤并发症（P=20.737，P<0.001）。MUST组1例（0.9%）AVG和非MUST组6例（4.9%）AVG发生移植物感染，两组间差异无统计学意义（P=0.121）。多因素Logistic回归显示，联合设施透析（比值比[OR]=2.713，95%置信区间[CI]：1.698 - 4.336，P<0.001）和良好的随访（OR=2.189，95%CI：1.221 - 3.927，P=0.009）是AVG中应用MUST的影响因素。
MUST可提高AVG的累积通畅率，降低干预频率和动脉瘤发生率，且不增加移植物感染风险。
