ABSTRACT
Objective:To construct a simple model of arteriovenous fistula classification,and to achieve the classification of arteriovenous fistula in hemodialysis patients.Methods:The study was a retrospective analysis, a total of 304 hemodialysis patients with internal fistula in People′s Hospital of Deyang City from January 2016 to January 2021 were selected by convenience sampling method,depending on whether the internal fistula was dysfunctional, patients were divided into 64 in the internal fistula failure group and 240 in the internal fistula patency group. Independent influence factors and their regression coefficient were obtained by single-factor analysis and logistic regression analysis, The risk score formula was established based on the regression coefficient to form a simple model of internal fistula classification.The model was evaluated by receiver operating characteristic curve and the scoring criteria for internal fistula classification was determined.Results:Logistic regression analysis showed that diabetes mellitus, hypotension, age≥60 years old, compression time≥30 min, blood phosphorus>1.78 mmol/L, triglyceride>1.71 mmol/L and fibrinogen>4 g/L were independent influencing factors of internal fistula failure (all P<0.05).The area under the receiver operating characteristic curve was 0.858(95% CI 0.789-0.928, P<0.01), and the best critical value of the internal fistula classification was 7.5, the sensitivity was 80.4% and the specificity was 84.8%. Conclusions:By obtaining the predictors of internal fistula failure, conducted the risk score, and constructed a simple model of internal fistula classification, which can effectively predicted the risk of internal fistula failure. It is conducive to the implementation of internal fistula classification management and the puncture of corresponding grade, to ensure the pathway safety of patients.
ABSTRACT
ObjectiveTo investigate the clinical effect of the double stapling technique for anus-preserved (Dixon) and Miles procedure of rectal carcinoma. MethodsFifty-eight cases were divided into 29 cases as control group and 29 cases as observation group by digital table method. The distance of their carcinoma was 4-7 cm to anus. The control group was treated with Miles procedure of rectal carcinoma, the observation group was treated with double stapling technique for Dixon. ResultsThe operation time of observation group was ( 180 ± 56) min, the control group was (240 ± 73)min(P ＜ 0.05). Five-year survival rate of observation group was 77.9％, the control group was 79.3％ (P ＞0.05);the recurrence rate of observation group was 6.9％(2/29),the control group was 6.9％(2/29) (P ＞ 0.05). In the observation group,nobody suffered encopresis after 1 year,postoperative stool frequency was ≤5 times/d,while the control group occurred encopresis gradually. ConclusionIf the distance of carcinoma is 4-7 cm to anus, the way of the double stapling technique for Dixon can get the similar short term effect with the way of Miles, and can get more ability to control it.