即穿型人工血管在血液透析通路中的应用与长期疗效分析  

Application and long-term efficacy analysis of early cannulation graft in hemodialysis access

作　　者：倪其泓[1] 赵意平[1] 王韦仑 杨硕菲[1] 张岚[1] 陈佳佺[1] NI Qi-hong;ZHAO Yi-ping;WANG Wei-lun(Department of Vascular Surgery,Renji Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院血管外科,上海200127

出　　处：《中国实用外科杂志》2023年第3期335-338,共4页Chinese Journal of Practical Surgery

基　　金：国家自然科学基金(No.82000447);上海交通大学医学院附属仁济医院培育基金(No.PYII-17-012);仁济医院科研种子基金(No.RJZZ19-10)。

摘　　要：目的 分析单中心即穿型人工血管应用于血液透析通路的36个月长期疗效。方法 回顾性分析上海交通大学医学院附属仁济医院自2018年1月至2019年12月收治的采用即穿型人工血管建立的移植物动静脉内瘘(AVG)病人的临床资料,搜集病人的基线资料、术中情况、术后穿刺时间、术后并发症及通畅率情况,根据病人的超声随访,分为规律随访组与未规律随访组,比较两组的通畅率。结果 总共有75例病人纳入研究,其中男性39例,女性36例,平均年龄为(60.1±15.8)岁,平均术后首次穿刺时间为(3.3±2.2)d。平均随访时间为(39.2±8.5)个月,术后12个月、24个月、36个月的一期通畅率分别为62.7%、40.0%、21.3%,一期辅助通畅率分别为77.3%、50.7%、33.3%,二期通畅率分别为94.7%、90.7%、89.3%。规律随访组的一期辅助通畅率显著高于未规律随访组(P值分别为0.026、0.027和0.008)。结论 即穿型AVG的长期通畅率结果满意,规律超声随访可以有效提高术后一期辅助通畅率,减少急性血栓形成。Objective To analyze the 36-month long-term efficacy of early cannulation graft in hemodialysis access at a single center.Methods From January 2018 to December 2019,Renji Hospital,School of Medicine,Shanghai Jiaotong University retrospectively analyzed the clinical data of patients with arteriovenous fistula(AVG)using early cannulation grafts in a single center.The baseline data,intraoperative conditions,postoperative puncture time,postoperative complications,and patency rate were collected.According to the ultrasonic follow-up of the patients,the patients were divided into a regular follow-up group and an irregular follow-up group,and the patency rates of the two groups were compared.Results A total of 75 patients were included in the study,including 39 males and 36 females.The average age was(60.1±15.8)years,and the average first puncture time after the operation was(3.3±2.2)days.The mean follow-up time was(39.2±8.5)months.The primary patency rates were 62.7%,40.0%,and 21.3%at 12,24,and 36 months,respectively.The primary assisted patency rates were 77.3%,50.7%and,33.3%,respectively.The secondary patency rates were 94.7%,90.7%,and 89.3%,respectively.The primarily assisted patency rate in the regular follow-up group was significantly higher than that in the irregular follow-up group.Conclusion The results of the long-term patency rate of early cannulation graft AVG are satisfactory.Regular ultrasound follow-up can effectively improve the primary assisted patency rate and reduce AVG thrombosis.

关 键 词：即穿型 人工血管 血液透析通路 通畅率 

分 类 号：R6[医药卫生—外科学]