小内径贵要静脉转位动静脉内瘘在血液透析中的应用  

Application of small diameter basilic vein transposition arteriovenous fistula to hemodialysis

作　　者：叶祖扬[1] 冷斌[1] 欧俊[1] 毕慧欣[1] 潘罅 邹迪莎 YE Zu-yang;LENG Bin;OU Jun;BI Hui-xin;PAN Xia;ZOU Di-sha(Department of Nephropathy,Affiliated Hospital of Guilin Medical University,Guilin 541001,China)

机构地区：[1]桂林医学院附属医院肾内科,桂林541001

出　　处：《上海交通大学学报（医学版）》2020年第2期276-278,共3页Journal of Shanghai Jiao tong University:Medical Science

基　　金：广西壮族自治区卫生和计划生育委员会科研项目(Z20170813);广西自然科学基金(2016GXNSFBA380057)。

摘　　要：目的·探讨小内径贵要静脉转位建立动静脉内瘘的通畅率及在血液透析应用中的临床意义。方法·回顾性分析2015年3月-2018年3月在桂林医学院附属医院肾内科行贵要静脉转位内瘘的18例患者,贵要静脉内径均<2 mm。研究分析其手术成功率、成熟时间、血液透析流量、可穿刺长度、不同时期通畅率、并发症等指标。结果·18例患者手术成功率为100%,术后6~10周内瘘均能成熟使用,血液透析流量200~280 mL/min,可穿刺长度15~20 cm,术后3、6、12个月的通畅率分别为100%、83.3%和61.1%。术后未出现相关并发症。结论·内径<2 mm的前臂贵要静脉可以行转位动静脉内瘘手术,且术后长期通畅率较高,并发症较少,可作为头静脉耗竭时的替代手术方案。Objective·To investigate the patency rate of small diameter basilic vein transposition arteriovenous fistula and its clinical application to hemodialysis.Methods·Eighteen patients with basilic vein transposition arteriovenous fistula from Mar.2015 to Mar.2018 were analyzed retrospectively in the Department of Nephrology,Affiliated Hospital of Guilin Medical University.The diameters of the patients’basilic veins were all<2 mm.The success rate,maturity time,hemodialysis blood flow,puncture length,patency rates at different periods and complications were studied.Results·The success rate of operations was 100%in the 18 patients.The fistulas all could be used 6-10 weeks after operations.The hemodialysis blood flow reached 200-280 mL/min,and the puncture length reached 15-20 cm.The patency rates of 3 months,6 months and 1 year after operations were 100%,83.3%and 61.1%,respectively.No complications occurred after operations.Conclusion·The basilic vein of forearm with diameter<2 mm can be performed with transposition arteriovenous fistula,and the long-term patency rate is relative high with few complications.It can be used as an alternative surgical scheme when the cephalic vein is exhausted.

关 键 词：血液透析 动静脉内瘘 贵要静脉 内径 

分 类 号：R692.5[医药卫生—泌尿科学]