血液透析通路术中桡动脉残端压的测定及应用  

Detection of the stubbed radial artery pressure and the clinical application during hemodialysis.

作　　者：范隆华[1] 朱迎春[2] 冯岗[2] 符伟国[1] 

机构地区：[1]复旦大学附属中山医院血管外科,上海200032 [2]复旦大学附属中山医院青浦分院肾内科

出　　处：《中国综合临床》2008年第1期75-76,共2页Clinical Medicine of China

基　　金：上海市青浦区科技发展基金资助项目（青科发2006.30）

摘　　要：目的研究血液透析用桡动静脉内瘘（AVF）术中，测定桡动脉残端压的方法和临床初步应用。方法桡AVF术中游离桡动脉2cm。桡动脉测压装置调零，将测压针向桡动脉远端穿刺，压力表指针平稳后，读取阻断前桡动脉血压。用血管夹阻断穿刺点近端的桡动脉，压力表指针平稳后，读取桡动脉残端压。根据桡动脉血压和残端压的结果，决定桡动脉和头静脉的吻合方式。结果对测压后行桡AVF术的患者随访6—8个月，无手指缺血征象，手指肌力Ⅴ级，患者AVF震颠良好。结论测定桡动脉残端压简单、方便，为研究阻断桡动脉后的手灌注压提供直接数据，指导临床实践。Objective To study the stubbed pressure during the construction of radial artorial-venous fistula （ AVF） and the primary clinical application. Methods Radial artery was isolated for about 2cm during the procedure. Before clamping radial artery, the pressure measurement system must be standardized. The radial artery was punctured by the needle of the measurement device, and the pressure was read before and after clamping the radial artery. The anastomosis style was depended on the results of the stubbed pressure. Results The length of follow-up was 6-8 months. All patients had no symptom of the digital ischemia, nor paralysis of the hand. All the radial artorialvenous fistulas were patency. Condusion It is a simple and convenient method to measure the stubbed blood pressure of the radial artery during the AYF procedure. The perfusion pressure of the hand after clamping the radial artery could direct the surgical approach.

关 键 词：血液透析 桡动静脉瘘 桡动脉压 

分 类 号：R459.5[医药卫生—治疗学]