动静脉内瘘术的改良及临床效果观察  

Technological Improvement and Clinical Observation of Arteriovenous Fistula

作　　者：孙路 彭芳丽[2] 余知灵 

机构地区：[1]江西省宜春市人民医院泌尿外科,336000 [2]宜春学院美容医学院

出　　处：《中国全科医学》2012年第18期2113-2115,共3页Chinese General Practice

摘　　要：目的探讨动静脉内瘘术的方法改良并总结其临床效果。方法分析我科2006年10月—2008年2月120例尿毒症患者采用传统的动静脉内瘘术及2008年3月—2011年10月308例尿毒症患者采用改良后的动静脉内瘘术的临床资料。结果传统组患者一次手术成功率为90%(108/120),改良组患者一次手术成功率为100%(308/308),两组一次手术成功率比较,差异有统计学意义(χ2=6.78,P<0.05)。两组术后不同时间的平均吻合口内径、通畅率及血流量比较,差异均有统计学意义(P<0.05)。结论液压扩张+选择性间断或连续缝合+吻合口上方静脉分支结扎方法行动静脉内瘘手术操作简便,吻合成功率高,并发症少,远期通畅率及血流量变化尚需观察。Objective To discuss the methods improvement of arteriovenous fistula surgery and to summarize the clini- cal efficacy. Methods Clinical data of 120 uremia patients who underwent traditional arteriovenous fistula surgery from October 2006 to February 2008 and 308 uremia patients who underwent improved arteriovenous fistula surgery from March 2008 to October 2011 in our department were retrospectively analyzed. Results The operative success rate of traditional group patients at one time was 90% （108/120） , the success rate of modified group patients was 100% （308/308）, the difference was statistically signifi- cant （ X2 = 6. 78, P 〈 0. 05 ） . The differences of anastomotic diameter, patency rate and blood flow of the two groups were statis- tieally significant （ P 〈 0. 05 ） . Conclusion The improved arteriovenous fistula surgery combined with fluid - widening therapy and selective continuous or interrupted suture technique and ligation of the branches of cephalic vein is featured by easy operation, high rate of success, and few complications. The long term effect remains to be seen.

关 键 词：动静脉瘘 动静脉吻合 肾透析 血流速度 

分 类 号：R692.5[医药卫生—泌尿科学]