上臂人工血管移植透析内瘘的建立及应用  

Expanded polytetrafluoroethylene graft vascular access for hemodialysis in the upper arm

作　　者：陆石[1] 韩国锋[1] 胡大勇[1] 于秀峙[1] 张金元[1] 

机构地区：[1]解放军第四五五医院肾脏病科,上海200052

出　　处：《中华泌尿外科杂志》2008年第8期550-552,共3页Chinese Journal of Urology

基　　金：基金项目;上海市卫生局科技发展基金资助项目（044109）

摘　　要：目的探讨上臂人工血管移植透析内瘘的建立方法及临床应用价值。方法参考国外文献设计了腋动脉与腋静脉建立上臂U形人工血管移植内瘘，腋动脉与肘窝贵要静脉作上臂直桥式内瘘，肱动脉与腋窝腋静脉制作上臂直桥式内瘘，采用3种方法为20例长期血液透析患者建立了上臂人工血管移植透析通路。患者男9例，女11例。年龄37～64岁，平均54岁。透析时间2～15年。结果20例手术操作均一次成功，术后6～8周用于临床穿刺透析，透析血流量220～300ml／min，血液再循环在正常范围，完全满足长期血液透析治疗的需要。结论当前臂或上臂由于各种原因不能制作自体动静脉内瘘和前臂血管移植内瘘时，上臂腋窝制作人工血管移植血管内瘘是行之有效的方法。Objective To investigate the application of expanded polytetrafluoroethylene（ePT-FE） grafts in upper arm to build arteriovenous access for hemodialysis. Methods ePTFE graft vas cular access was built in the upper arm in 20 uremia patients. Three operation strategies were applied according to the reference, including loop grafts connected axillary artery and axillary vein, straight graft connected axillary artery and elbow basilic vein, and bridge connected elbow brachial artery and axillary vein. Results Twenty operations were successful and after 6-8 weeks the fistula of all cases were used in hemodialysis. The blood flows were 220-300ml/min without re-circulation found. Conclusion ePTFE graft arteriovenous vascular access in the upper arm could be an alternative for hemodialysis patients who are difficult to build native arteriovenous fistula.

关 键 词：肾透析 血管瘘 临床分析 治疗方法 

分 类 号：R692.5[医药卫生—泌尿科学]