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在一项回顾性队列研究中,血液透析通路类型会影响终末期肾病患者的伤口愈合并发症及生存率。

Hemodialysis pathway types influence wound healing complications and survival in end-stage renal disease patients in a retrospective cohort study.

作者信息

Ding Jie, Li Jun

机构信息

Hemodialysis Ward, Wuhan Third Hospital, Tongren Hospital of Wuhan University, No. 216 Guanshan Avenue, Hongshan District, Wuhan, 430074, Hubei, China.

出版信息

Sci Rep. 2025 May 15;15(1):16866. doi: 10.1038/s41598-025-01602-1.

Abstract

This study evaluates the impact of different hemodialysis access types-central venous catheter (CVC), arteriovenous graft (AVG), and autologous arteriovenous fistula (AVF)-on wound healing, complication rates, and long-term survival in patients with end-stage renal disease (ESRD). A retrospective analysis of 323 ESRD patients receiving hemodialysis over a ten-year period revealed significant differences in outcomes across the three groups. AVF patients experienced the shortest wound healing times and the highest dialysis efficacy, while the CVC group had the highest infection and reoperation rates. Although there were no significant differences in cardiac function or cause-specific mortality, AVF patients had the longest median survival time, followed by those in the CVC and AVG groups. These findings suggest that while AVF provides superior dialysis efficiency and survival outcomes with fewer complications, patient suitability and individual health conditions must be carefully considered when selecting the appropriate vascular access for hemodialysis.

摘要

本研究评估了不同血液透析通路类型——中心静脉导管(CVC)、动静脉移植物(AVG)和自体动静脉内瘘(AVF)——对终末期肾病(ESRD)患者伤口愈合、并发症发生率及长期生存率的影响。一项对323例接受了为期十年血液透析的ESRD患者的回顾性分析显示,三组患者的治疗结果存在显著差异。AVF患者的伤口愈合时间最短,透析效果最佳,而CVC组的感染率和再次手术率最高。尽管在心脏功能或特定病因死亡率方面无显著差异,但AVF患者的中位生存时间最长,其次是CVC组和AVG组患者。这些研究结果表明,虽然AVF能提供更高的透析效率和生存结果,且并发症较少,但在为血液透析选择合适的血管通路时,必须仔细考虑患者的适用性和个体健康状况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54f7/12081909/da2f3be72db9/41598_2025_1602_Fig1_HTML.jpg

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