高位动静脉内瘘与前臂人工血管的临床比较  

Clinical comparison between high arteriovenous fistula and forearm artificial blood vessel

作　　者：易琴霞 YI Qinxia(Jiujiang Hospital of Traditional Chinese Medicine,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市中医医院,江西九江332000

出　　处：《当代医学》2021年第13期65-67,共3页Contemporary Medicine

摘　　要：目的比较高位动静脉内瘘术与前臂人工血管动静脉内瘘术的治疗效果。方法选取2015年8月至2019年11月本院收治的尿毒症患者40例,按照手术方案不同分为两组,各20例。对照组采用高位动静脉内瘘术,观察组采用前臂人工血管动静脉内瘘术。比较两组手术成功率、术中出血量、手术时间、术后并发症发生率、手术前后心功能(心输出量、射血分数)、手术期间血流动力学[心率(HR)、收缩压(SBP)、舒张压(DBP)]及中心静脉狭窄程度。结果观察组手术成功率85.00%(17/20)与对照组90.00%(18/20)比较差异无统计学意义。观察组术中出血量多于对照组,手术时间长于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率40.00%(8/20)高于对照组20.00%(4/20),但差异无统计学意义。手术开始后10、20 min,观察组HR、SBP、DBP水平均有好转,且改善程度优于对照组,差异有统计学意义(P<0.05)。术后,观察组心输出量、射血分数高于对照组(P<0.05)。观察组中心静脉造影率(5.00%)低于对照组(40.00%),观察组感染率(45.00%)高于对照组(10.00%),差异有统计学意义(P<0.05)。结论与传统高位动静脉内瘘术比较,前臂人工血管动静脉内瘘术手术难度较高,术后感染风险较大,但其对中心静脉及心脏影响较小,穿刺难度小,无误穿肱动脉出血的风险,保留了自身血管资源,优于传统高位动静脉内瘘术。Objective To compare therapeutic effects of high arteriovenous fistula and forearm artificial vascular arteriovenous fistula.Methods From August 2015 to November 2019,40 patients with uremia were selected and divided into two groups according to different surgical schemes,with 20 cases in each group.The control group was treated with high arteriovenous fistula,while the observation group was treated with forearm artificial vascular arteriovenous fistula.The two groups were compared in terms of operation success rate,intraoperative blood loss,operation time,postoperative complication rate,cardiac function before and after operation(cardiac output,ejection fraction),hemodynamics during surgery[heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP)]and central vein stenosis before and after operation.Results There was no significant difference between the success rate of 85.00%(17/20)in the observation group and 90.00%(18/20)in the control group.The intraoperative blood loss of the observation group was more than that of the control group,the operation time was longer than that of the control group,the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 40.00%(8/20),which was higher than 20.00%(4/20)in the control group,but the difference was not statistically significant.10 min and 20 min after operation,HR,SBP and DBP levels of the observation group were improved,and the improvement degree was better than that of the control group,the difference was statistically significant(P<0.05).After operation,the cardiac output and ejection fraction of the observation group were higher than those of the control group(P<0.05).The central venography rate of the observation group(5.00%)was lower than that of the control group(40.00%),the infection rate of the observation group(45.00%)was higher than that of the control group(10.00%),the difference was statistically significant(P<0.05).Conclusion Compared with traditional high-level arterio

关 键 词：高位动静脉内瘘术 前臂人工血管动静脉内瘘术 效果 

分 类 号：R692.5[医药卫生—泌尿科学]