131例人工血管移植物内瘘中期随访结果  

Mid-term follow-up results of 131 cases of arteriovenous graft patency

作　　者：彭嘉欣 万恒[1] Peng Jiaxin;Wan Heng(Department of Vascular and Intervention,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院血管与介入科,广州510515

出　　处：《中华普通外科杂志》2021年第4期286-289,共4页Chinese Journal of General Surgery

基　　金：南方医科大学临床研究启动计划培育项目(LC2016PY009);南方医院新业务新技术院级课题(2013028)。

摘　　要：目的评估人工血管移植物内瘘(AVG)用于维持性血液透析的中期结果。方法回顾性分析南方医科大学南方医院血管外科2014年1月至2016年12月收治的131例建立AVG患者的临床资料。结果患者术后中位随访时间22.8个月(2~61个月)。患者AVG术后平均初级通畅时间为(22.20±1.97)个月,1、2、3年初级通畅率分别为61.5%、36.6%和23.2%。AVG术后平均次级通畅时间为(38.30±2.30)个月,术后的1、2、3年次级通畅率分别为85.6%、68.6%和55.8%。AVG术后出现血栓形成65例(49.6%),通路狭窄50例(38.2%),移植物感染13例(9.9%),假性动脉瘤2例(1.5%),透析通路相关性肢端缺血综合征2例(1.5%),血清肿2例(1.5%)。结论AVG初级通畅率较自体动静脉内瘘(AVF)差,但通过修复手术能达到较满意的次级通畅率。术后规律随访,早期发现狭窄病变并进行相应处理,是维持AVG远期通畅的关键。Objective To evaluate the mid-term follow-up results of arteriovenous graft(AVG)for patients on maintenance hemodialysis.Methods The clinical data of 131 patients who implanted AVG from Jan 2014 to Dec 2016 at Department of Vascular Surgery,Nanfang Hospital,Southern Medical University were retrospectively analyzed.Results The mean follow-up time was 22.8 months(ranging from 2 to 61 months).The average primary patency time after AVG was(22.20±1.97)months,and the primary patency rates at 1 year,2 years,3 years were 61.5%,36.6%and 23.2%,respectively.The average secondary patency time after AVG was(38.30±2.30)months,and the secondary patency rates after 1 year,2 years,3 years were 85.6%,68.6%,and 55.8%,respectively.Sixty five(49.6%)patients had thrombosis after operations,50(38.2%)had access stenosis,13(9.9%)had graft infections,and 2(1.5%)had pseudoaneurysm,2(1.5%)had hemodialysis access-induced distal ischemia,2(1.5%)had seroma.Conclusions Though the primary patency rate of AVG is worse than that of arteriovenous fistula(AVF),a satisfactory secondary patency rate can be achieved through repair treatments.Regular follow-up,early detection of stenotic lesions and treatments are vital for long-term patency of AVG.

关 键 词：血液滤过 移植物闭塞 血管 通畅率 并发症 

分 类 号：R692.5[医药卫生—泌尿科学]