前臂远端贵要静脉转位建立自体血管内瘘手术  

The distal basilic vein transposition arteriovenoos fistulas for hemodialysis access

作　　者：孙静[1] 安茂竹[1] 张宏[1] 付海霞[1] 刘贤华[1] 秦伟[1] 梁孝梅[1] 

机构地区：[1]山东省日照市人民医院血液净化科,276800

出　　处：《国际移植与血液净化杂志》2010年第2期27-29,共3页International Journal of Transplantation and Hemopurification

摘　　要：目的探讨前臂远端贵要静脉转位建立自体血管内瘘的方法。方法自2007年12月至2009年12月我们对26例维持性血液透析患者进行前臂远端贵要静脉转位建立自体血管内瘘手术治疗。26例中有17例为原桡动脉一头静脉内瘘因并发症失去功能，9例初次行血管内瘘手术。手术方式采用贵要静脉转位与肱动脉端侧吻合；贵要静脉转位与桡-动脉端端吻合；贵要动脉与尺动脉端侧或端端吻合，吻合口直径为5．0—8．0min。结果26例患者中有1例因术后血肿压迫闭塞，2例因术后内瘘成熟不良，其余手术患者一次取得成功，术后血流量达200-350ml／min。对患者的心功能未造成不良影响，也未出现严重并发症。结论只要适应证选择合适，前臂远端贵要静脉转位建立自体血管内瘘手术，是尽量利用自身血管条件。建立内瘘的一种行之有效的方法。Objiective To investigate surgically created the distal basilic vein transposition arteriovenom fistulas for hemodialysis access. Methods The study reviewed consecutive patients in whom distal basilic vein transposition arteriovenous fistulas were created from December 2007 to December 2009. The basilic vein was anastomosed to the ulnar artery or was transposed and anastornosed to the radial artery or to the braehial artery. Results A VF creation was successful in 23 patients （ 86.7 % ）. The blood flow were reached 200 - 350 ml/min after operation. There are no any side significant affects on cardiac function. Conclusions AVFs utilizing the forearm basilie vein can be considered for pfimaxy or secondary vascular access because of the acceptable survival rate and low incidence of hand ischemia. Transposition of the basilie vein is a valuable option in the reconstruction of a thrombosed or stenosed radial- cephalic fistula.

关 键 词：前臂 贵要静脉 转位 血管内瘘 

分 类 号：R473.6[医药卫生—护理学]