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[目的]探讨维持性血液透析(MHD)患者血管通路选择及相关并发症发生和抗凝治疗情况.[方法]本院进行MHD治疗的88例患者,按照血管通路选择的不同分为长期留置中心静脉导管组(CVC,n=10)与自体动静脉内瘘组(AVF,n=78),比较两组抗凝治疗情况及并发症发生率.[结果]①本组选择 AVF通路原发病为肾小球肾炎患者居多,CVC通路则以糖尿病肾病居多,且 AVF 组总透析时间长于 CVC 组(P<0.05);②CVC组使用低分子肝素(LMWH)抗凝剂所占比例高于 AVF组(P0.05);③CVC组血栓并发症发生率高于 AVF组(P0.05),AVF 组血管通路栓塞发生率明显低于 CVC 组(P<0.05);④AVF 及CVC组出现血栓并发症患者普通肝素(UFH)抗凝剂使用剂量均高于出血并发症患者(P<0.05).[结论]采用CVC血管通路 MHD患者其血栓并发症发生率较高,抗凝治疗以 LMWH 为主,药物使用剂量规范性、标准性欠佳,需进一步规范抗凝药物治疗.“,”[Objective]To explore the selection of vascular access and incidence of related complications in patients with maintenance hemodialysis(MHD)and analyze the conditions of anticoagulant therapy.[Methods]A total of 88 patients with MHD in our hospital were divided into long-term indwelling central venous catheter group (CVC,n=10)and autologous internal arteriovenous fistula group (AVF,n=78).The status of antico-agulant therapy and incidence of complications were compared between the two groups.[Results]①Most of the patients who chose AVF pathway were patients whose primary disease was glomerulonephritis,while most patients who chose CVC pathway were female and diabetic patients.The total duration of hemodialysis in the AVF group was longer than that in the CVC group (P<0.05).②In the CVC group,the proportion of pa-tients using low molecular weight heparin(LMWH)anticoagulant was higher than that in the AVF group (P0.05).③The incidence of thrombotic complications in the CVC group was higher than that in the AVF group (P 0.05).The incidence of thrombosis in AVF group was significantly lower than that in CVC group (P <0.05).④The dosage of anticoagulants of patients with thrombotic complications in the two groups was higher than that of patients with bleeding complications (P <0.05).[Conclusion]The incidence of thrombotic complications is higher in MHD patients with CVC vascular access.Anticoagulant therapy is based on LMWH. However,the dose and standard of drug use are not so good and the anticoagulant therapy needs to be further standardized.