肱动脉-贵要静脉内瘘与动静脉移植物内瘘在长期血液透析患者中的应用  

Brachial-basilic arteriovenous fistula versus arteriovenous graft in vascular access for mainteinance hemodialysis patients

作　　者：高民[1] 汤日宁[1] 杨金芳[1] 张留平[1] 王越[1] 刘宏[1] 涂岩[1] 刘必成[1] 

机构地区：[1]东南大学附属中大医院肾内科,南京210009

出　　处：《中华医学杂志》2013年第15期1150-1152,共3页National Medical Journal of China

基　　金：基金项目：江苏省自然科学基金（BK2011603）

摘　　要：目的比较肱动脉一贵要静脉动静脉内瘘和动静脉移植物内瘘在长期血液透析（血透）患者中的临床应用效果。方法选择东南大学附属中大医院肾内科2008年1月1日至12月31日期间的复杂血管通路患者61例，经医院伦理委员会审核，数字表法随机分为2组：肱动脉一贵要静脉动静脉内瘘（31例），人工血管建立动静脉移植物内瘘（30例），比较两组内瘘的3个月、1、2、3年的通畅率及并发症发生率。结果肱动脉．贵要静脉动静脉内瘘组3个月、1、2、3年的通畅率为100％、96．8％、90．3％、87．1％，3年累计感染率3．2％，栓塞率3．2％；动静脉移植物内瘘组3个月、1、2、3年的初级通畅率为96．7％、50．0％、36．7％、33．3％，3年累计感染率26．7％，栓塞率33．3％。肱动脉一贵要静脉动静脉内瘘组的1、2、3年的通畅率比动静脉移植物内瘘组高，且肱动脉-贵要静脉动静脉内瘘组的感染和栓塞并发症比动静脉移植物内瘘组低，差异均有统计学意义（均P〈0．05）。结论肱动脉-贵要静脉动静脉内瘘具有通畅率高、感染和栓塞发生率低的优点，优于使用人工血管建立的动静脉移植物内瘘。Objective To compared the outcomes of autogenous brachial-basilic arteriovenous fistula （BBAVF） and AV graft （AVG） in patients undergoing long-term hemodialysis. Methods Approved by Zhong Da hospital ethics committiee, we analyzed 61 complex patients, 30 randomized to receive AVG and 31 received BBAVF. We compared patency rates of BBAVF and AVG in 3 months, 1 year, 2 years, 3 years, and complication rates. Results Patency rates of BBAVF in 3 months, 1 year, 2 years, 3 years were 100% , 96.8% , 90. 3% , 87.1% , 3 years accumulative total infection rate was 3.2% , thrombosis rate was 3.2% . Patency rates of AVG in 3 months, 1 year, 2 years, 3 years were 96.7% , 50.0% , 36. 7% , 33.3% , 3 years accumulative total infection rate was 26. 7% , thrombosis rate was 33.3%. Patency rates of BBAVF in 1 year, 2 years, 3 years were higher than patency rates of AVG. The complication rates of infection and thrombosis were significantly lower for BBAVF than for AVG （P〈0.05, respectively）. Conclusions BBAVF has the advantage of a higher patency rate, a lower complicantion rates of infection and thrombosis, should be served as a favourable choice in building the vascular access in maintenance hemodialysis patients.

关 键 词：动静脉瘘 移植物 透析 肱动脉 贵要静脉 

分 类 号：R45[医药卫生—治疗学]