浅静脉流出道对人工血管动静脉内瘘 通畅率影响的比较  

Comparison of the effect of superficial venous outflow tract on the patency rate of arteriovenous graft

作　　者：缪鹏[1] 谭正力[1] 姚辰亮 田然[1] 郁正亚[1] Miao Peng;Tan Zhengli;Yao Chenliang;Tian Ran;Yu Zhengya(Department of Vascular Surgery,Beijing Tongren Hospital,Capital Medical University,Department of Vascular Surgery of Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院血管外科,首都医科大学血管外科学系,北京100730

出　　处：《中国血管外科杂志（电子版）》2022年第3期229-232,247,共5页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的比较建立前臂人工血管动静脉内瘘(arteriovenous graft,AVG)时选择不同浅静脉流出道对于人工血管通畅率的影响。方法回顾性分析首都医科大学附属北京同仁医院2016年7月至2020年7月建立前臂AVG的210例患者临床资料。患者根据浅静脉流出道的不同分为肘正中静脉(median cubital vein,MCV)、贵要静脉(basilic vein,BV)组和头静脉(cephalic vein,CV)组,比较三组术后通畅率。结果MCV组术后12、24、36和48个月的一期通畅率分别为45.5%、16.9%、7.5%和3.7%,BV组分别为47.2%、15.8%、8.2%和5.5%,CV组分别为58.9%、26.5%、15.1%和9.7%。MCV组术后12、24、36和48个月的一期辅助通畅率分别为45.5%、23.3%、10.7%和8.5%,BV组分别为60.4%、32.9%、20.2%和12.0%,CV组分别为71.4%、35.5%、16.8%和10.0%。MCV组术后12、24、36和48个月的二期通畅率分别为83.0%、49.8%、26.3%和15.9%,BV组分别为78.9%、56.2%、39.7%和26.8%,CV组分别为87.5%、67.7%、46.6%和26.3%。差异均无统计学意义(P>0.05)。结论不同浅静脉流出道建立AVG术后近中期通畅率无明显差异,可依据临床情况个体化选择治疗方案。Objective To compare the effects of different superficial venous outflow tracts on the patency rate of forearm arteriovenous graft(AVG)establishing.Methods The clinical data of 210 patients with forearm AVG established from July 2016 to July 2020 in Beijing Tongren Hospital,Capital Medical University were analyzed retrospectively.The patients were divided into median cubital vein(MCV)group,basic vein(BV)group and cephalic vein(CV)group according to different superficial vein outflow tracts.The postoperative patency rates of the three groups were compared.Results The primary patency rates at 12,24,36 and 48 months after surgery were 45.5%,16.9%,7.5%,and 3.7%in the MCV group,47.2%,15.8%,8.2%and 5.5%in the BV group,and 58.9%,26.5%,15.1%and 9.7%in the CV group,respectively.The primary assist patency rates at 12,24,36,and 48 months after surgery were 45.5%,23.3%,10.7%and 8.5%in the MCV group,60.4%,32.9%,20.2%and 12.0%in the BV group,and 71.4%,35.5%,16.8%and 10.0%in the CV group,respectively.The secondary patency rates at 12,24,36,and 48 months after surgery were 83.0%,49.8%,26.3%and 15.9%in the MCV group,78.9%,56.2%,39.7%and 26.8%in the BV group,and 87.5%,67.7%,46.6%and 26.3%in the CV group,respectively.The difference was not statistically significant(P>0.05).Conclusion There is no significant difference in the short-and mid-term patency rate after AVG with different superficial venous outflow tracts.Individual design for therapy should be considered for different patients.

关 键 词：血液透析 人工血管动静脉内瘘 静脉 流出道 通畅率 

分 类 号：R543[医药卫生—心血管疾病]