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The management of vascular access in hemodialysis patients during the coronavirus disease 2019 epidemic: A multicenter cross-sectional study.

冠状病毒疾病2019流行期间血液透析患者血管通路的管理: 一项多中心横断面研究。

  • 影响因子:1.12
  • DOI:10.1177/1129729820937484
  • 作者列表:"Shi J","Yan JJ","Chen J","Zhang QH","Yang Y","Xing X","Cheng AY","Wang YN","Xu G","He F
  • 发表时间:2021-03-01
Abstract

BACKGROUND:Coronavirus disease 2019 is an epidemic disease throughout the world. The management of vascular access during the epidemic is currently unknown. METHODS: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. RESULTS: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. CONCLUSION: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.

摘要

背景: 冠状病毒疾病2019是一种在世界范围内流行的疾病。流行病期间血管通路的管理目前尚不清楚。 方法: 在这项多中心横断面研究中,我们收集了湖北省44家医院2020年1月22日至3月10日期间接受血液透析患者的血管通路数据。我们估计了2019冠状病毒疾病爆发期间血管通路的管理。 结果: 在纳入的9231例血液透析患者中,5387例患者 (58.4%) 为男性,2959例患者 (32.1%) 年龄大于65岁。动静脉内瘘是血管通路的主要类型,占76.5%; 496例 (5.4%) 患者发生血管通路并发症; 导管流量减少是最常见的血管通路并发症,狭窄是动静脉通路的主要并发症。在初诊尿毒症患者中,共安置了280个血管通路部位,其中260例 (92.8%) 接受了导管插入术; 为治疗血管通路并发症,实施了149例抢救程序,包括132例导管、7例经皮腔内血管成形术、6例动静脉瘘修补术和4例动静脉瘘。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; 确诊和疑似冠状病毒病的患者分别为69和142,占2019。共有146例患者死亡,其中29例 (19.9%) 患者因血管通路并发症死亡。 结论: 导管流量减少和动静脉通路狭窄是血管通路的主要并发症。建立的大多数血管通路部位是导管,并且许多血管通路并发症仍然没有得到治疗。

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