股动脉-股深动脉人工血管旁路术建立长期血透通路14例报告  

Artificial Vascular Graft Between Femoral Artery and Deep Femoral Artery as the Permanent Hemodialysis Blood Access in 14 Hemodialysis Cases

作　　者：毛明锋[1] 叶蔚蔚[1] 吴华芬[1] 吕春燕[1] 金烈[1] 王剑[1] 

机构地区：[1]浙江省丽水市中心医院肾内科,丽水323000

出　　处：《中国中西医结合肾病杂志》2013年第9期793-795,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：浙江省丽水市科技局计划项目(No.2012JYZB85)

摘　　要：目的：探索一种适合传统方法难以建立自体动静脉内瘘和人工动静脉内瘘患者的新的血管通路建立方法，确保该部分透析患者血管通路的安全。方法：对我院2012年1月以来14例因自体血管条件差、周围血管耗竭等原因无法建立自体动静脉内瘘，而以人工血管动静脉内瘘方式建立移植血管通路则存在缺乏合适的静脉吻合口的患者，采用股动脉一股深动脉人工血管旁路术建立长期血透通路，并观察术后并发症、通畅率、血流量等以评估该种通路的可靠性、安全性。结果：14例患者均一次手术成功，随访2～13个月，通畅率100％，血流量达250～300ml／min，1例因透后压迫不当出现皮下血肿，1例发生切开处感染。1例发生切口脂肪液化。未发生血栓形成、狭窄、人工血管感染、肢体肿胀、心功能不全等并发症。结论：股动脉一股深动脉人工血管旁路术建立长期血透通路具有手术操作简单、符合生理、血流量充分、穿刺部位多、术后无静脉高压、不增加心脏负荷等优点。为传统方法难以建立长期血管通路的患者提供了一种全新的血管通路选择，具有一定的应用前景。Objective：the aim of this study was to search for a suitable methods to set up hemodialysis blood access for those who can not build native arteriovenous fistula or artificial arteriovenous fistula, we make sure the hemodialysis blood access is safe for those one. Methods：we analysis 14 patients who can not set up native arteriovenous fistula or artificial arteriovenous fistula because of poor vascular condition, we set up artificial vascular Graft between femoral artery and deep femoral artery as the permanent hemodialysis blood access in the 14 patients . we assess the reliability and safety of the new hemodialysis blood access by analysis complication, patency rate, blood flow volume after the surgery. Results：All cases had the operation successfully, we took the follow up visite for 2 ～ 13 months, the pateney rate was 100% ,the blood flow volume is 250 ～ 300 ml/min, one case have subcutaneous hemato- ma because of improper oppression. One case had infection on the operative incision. One case had fat liquefaction on the operative incision, there is no thrombogenesis, hemadostenosis, vascular infection, limb swelling or heart failture. Conclusion：Artificial vascular Graft between femoral artery and cleep femoral artery as the permanent hemodialysis blood access have several advantage, first Surgical operation is simple, second the blood flow Conform to the physiology and the blood volume is sufficient, third the blood access have enough siteofparacentesis and do not add any cardiac load. fourth there is no venous hypertension after the surgery, so the Artificial vascular Graft between femoral artery and deep femoral artery as the permanent hemodialysis blood access have promising prospects for the the patients who can not set up traditional hemodialysis access.

关 键 词：聚四氟乙烯 血管通路 血液透析 

分 类 号：R473.5[医药卫生—护理学]