自体动静脉内瘘成形术中远端桡动脉和头静脉端－端吻合与端－侧吻合临床对比研究  

A clinical comparison of end-to-end and end-to-side nastomosis between the distal radial artery and cephalic vein during autologous internal arteriovenous fistula

作　　者：张丽[1] 王惠新[1] 

机构地区：[1]徐州市中心医院肾内科,江苏徐州221009

出　　处：《徐州医学院学报》2015年第10期711-713,共3页Acta Academiae Medicinae Xuzhou

摘　　要：目的：通过对比尿毒症造瘘患者动静脉瘘端－端吻合与端－侧吻合的优缺点，探索动静脉造瘘的最佳方法。方法回顾性分析我院2011年1月—2014年1月住院期间接受动静脉造瘘手术的262例尿毒症患者的临床资料，其中86例患者（ A组）行前臂远端桡动脉和头静脉端－端吻合术，176例患者（ B组）行前臂远端桡动脉和头静脉端－侧吻合术，分析A、B两组患者术后并发症发生率、8周内瘘成熟率、2个月后透析流量与1、3年通畅率。结果 A组患者8周内瘘成熟率、窃血综合征发生率高于B组（P＜0．05），两组1、3年通畅率及2个月后透析流量≥300 ml／min患者所占比例的差异无统计学意义（P＞0．05）。结论两种吻合造瘘方法在长期透析使用时无明显差异。Objective To explore an optimum approach for artificial arteriovenous fistula through comparison of end-to-end and end-to-side nastomosis between the distal radial artery and cephalic vein in uremia patients.Methods A retrospective analysis was conduct, using clinical data from 262 uremia patients receiving fistula operation from Janu-ary 2011 to January 2014 in our hospital.Among these patients were 86 patients （ Group A） receiving end-to-end an-astomosis between the distal forearm radial artery and cephalic vein, and 176 patients （ Group B） receiving end-to-side anastomosis between the distal forearm radial artery and cephalic vein.Then, both groups were compared for the in-cidence of postoperative complications, fistula maturation rate within eight weeks, dialysis flow after two months and reca-nalization rate within one and three years.Results Group A produced increases in fistula maturation rate within eight weeks and steal syndrome incidence than Group B （P〈0.05）.No statistical difference was found between both groups as to dialysis flow after two months and recanalization rate within one and three years.Conclusion No remarkable differ-ence was found between both approaches during long-term dialysis.

关 键 词：动静脉内瘘 尿毒症 

分 类 号：R734.1[医药卫生—肿瘤]