The Relevant Factors Analysis Of The Early Patency Rate Of Arteriovenous Fistula

Objective：Through the collection of the first time forearm arteriovenous fistula (AVF)surgery in end stage renal disease (end stage renal disease. ESRD) patients withpreoperative clinical indicators, analyze the relationship between the indicators andthe success rate of operation, and screen out the relevant factors, so as to achieve thepurpose to improve the surgical success rate.Methods：According to the method and the theory of clinical epidemiology, we chose1051end-stage renal disease patients in our hospital, whom with forearm AVF forthe first time had been asked by unified questionnaire. We surveyed and registeredthe patient’s age, gender, type of work, the primary disease, side of surgery,proteinuria, left ventricular ejection fraction (EF), blood pressure (BP，3daysbefore surgery to3days after surgery, the systolic and diastolic blood pressure of themorning and afternoon), hemoglobin (HB), platelets (PLT), coagulation function(PT、APTT、Fbg、TT), serum albumin (ALB), serum creatinine (Scr), blood lipids(TC, TG), arterial and venous diameter, color Doppler ultrasound arterial diameterand blood flow index register. All the patients were surgeried by the same operater.Within a week after the AVF,we had tremor auscultation of hair-like or shootinglike vascular murmur in the vicinity of the anastomosis as the standard to judge thesuccess, and recorded the result. We used SPSS13.0to establish a databaseapplication for statistical analysis, then did the statistical description and statisticalinference. We analyzed the success rate of arteriovenous fistula using multivariateunconditional Logistic regression analysis, so as to get main factors for the AVF.Results：The success rate and failure rate of AVF surgery of First Affiliated Hospital ofNanchang University is(96.10%) and (3.90%) respectively. The single factor non-conditional Logistic regression analysis showed that proteinuria, hemoglobin,platelets, total cholesterol, cephalic vein diameter of the radial artery diameter, diastolic blood pressure are related with the operation’s success rate.Non-conditional Logistic regression analysis showed that there are4factors affectingthe operation, which are cephalic vein diameter (OR=2.085), radial artery diameter(OR=1.767), total cholesterol (OR=0.708),2days prior to am on day of surgery,the average diastolic blood pressure (OR=1.057).Conclusions：By using cephalic vein diameter、radial artery diameter、total cholesterol、2daysprior to the surgery to the surgery morning of the average diastolic blood pressure aspredictors of the success rate of arteriovenous fistula, we may find some predictivevalue. By examining the fore kinds of indicators to predict the success rate, thismethod is simple, facilitating the clinical application, and has a wide applicationprospect.