自体动静脉内瘘术156例临床分析  

Clinical investigation of 156 cases ateriovenous fistula operation

作　　者：席春生[1] 王世勇[2] 薛云[2] 方春天 张英[1] 张萌[1] 李亚妹[1] 

机构地区：[1]兰州军区兰州总医院肾脏病内科,甘肃兰州730050 [2]兰州军区兰州总医院骨科研究所,甘肃兰州730050

出　　处：《中国现代医学杂志》2014年第14期61-63,共3页China Journal of Modern Medicine

摘　　要：目的总结维持性血液透析终末期肾脏病患者行自体动静脉内瘘术以建立血管通路的经验，为规范化建立和使用维护动静脉内瘘提供依据。方法采用回顾性调查的研究方法，分析兰州军区兰州总医院2012年6月1日-2013年5月31日156例自体动静脉内瘘术的患者资料，记录动静脉内瘘术患者的人口统计学资料、原发疾病、术前评估、术中情况、吻合血管、吻合方式以及术后并发症情况。结果156例患者术后一期吻合通畅率达100％，但有6例患者术后出现血栓形成，行手术取栓＋内瘘重建术。动静脉内瘘吻合血管依次为桡动脉-头静脉96％，桡动脉-贵要静脉2％，尺动脉-贵要静脉2％；瘘管吻合方式端侧吻合54％，端端吻合46％，侧侧吻合0％；术中血管痉挛6例占3．8％，术后急性血栓形成6例占3．8％，肿胀手1％。结论①详尽的术前评估，熟练的术中显微外科技术，严格的术后观察，是成功建立一条理想血管通路的关键；②基础疾病、心脑血管疾病、糖尿病以及反复穿刺血管是自体动静脉内瘘术失败的主要原因。[Objective] To investigate ateriovenous fistula （AVF） in our hemodialysis patients in Lanzhougeneral hospital hemodialysis center. [Methods] 156 patients were recruited in the study in 2012. Their ate-riovenous fistula types and complications were recorded. [Results] The total primary success rate was 100%,6 cases AVF developed thrombosis. The radio-cephalic anastomosis was the most common site for AVF. Theend-side was 54%, and end-end was 46%. [Conclusion] Try to successively create an ideal autologous AVFneed carefully evaluate before operation, skillfully operate, strictly management after operate. The underlyingdisease such as CVD was important factor for autologous AVF.

关 键 词：血管通路 动静脉内瘘 维持性血液透析 临床研究 

分 类 号：R459.5[医药卫生—治疗学]