即穿型人工血管在血管通路中的应用效果及并发症分析  

Application and complication of the promptly used type of artificial blood vessel for vascular access

作　　者：刘城[1] 温玉[1] 杨雪 林泽洪 张振华 LIU Cheng;WEN Yu;YANG Xue;LIN Ze-hong;ZHANG Zhen-hua(Department of Nephrology,People’s Hospital of Ziyang,Ziyang 641399,China)

机构地区：[1]资阳市人民医院肾内科,资阳641399

出　　处：《中国血液净化》2024年第2期143-146,共4页Chinese Journal of Blood Purification

摘　　要：目的 研究即穿型人工血管在血管通路中的应用效果及并发症。方法 选取从2019年2月—2022年2月于资阳市人民医院接受人工血管内瘘手术的83例患者为研究对象。将流出道静脉直径>4mm分为即穿型人工血管组(n=41),流出道静脉直径3~4 mm分为膨体聚四氟乙烯(expanded polytetrafluoroethylen,ePTFE)人工血管组(n=42),分别选用即穿型人工血管、ePTFE人工血管进行造瘘手术。对所有患者均实施为期18个月的随访,比较2组手术后通畅率,治疗效果,手术后并发症,手术后生存率。结果 即穿型人工血管组与e PTFE人工血管组手术后6、12、18个月初级通畅率(t=1.437、0.609、0.595,P=0.231、0.435、0.441)及次级通畅率(t=2.108、0.149、0.310,P=0.147、0.699、0.578)对比无统计学差异。即穿型人工血管组首次穿刺时间、手术后透析导管移除时间均短于ePTFE人工血管组(t=78.386、21.491,均P<0.001);2组手术后透析血流量及人工血管使用率对比均不明显(t/χ^(2)=0.214、0.988,P=0.831、0.320)。即穿型人工血管组手术后肿胀、血栓形成发生率均低于ePTFE人工血管组(χ^(2)=24.418、7.540,P<0.001、0.006)。2组手术后6、12、18个月患者生存率对比均不明显(χ^(2)=1.037、0.239、0.183,P=0.309、0.625、0.668)。结论 即穿型人工血管应用于血管通路中可实现早期穿刺,通畅率高,且并发症发生风险较低,值得推广应用。Objective To study the effect and complication of the promptly used type of artificial blood vessel for vascular access.Methods A total of 83 patients undergoing the surgery of artificial blood vessel implement in People’s Hospital of Ziyang during February 2019 to February 2022 were recruited as the re-search subjects.According to the diameter of outflow vein,they were divided into promptly used type of artifi-cial blood vessel group(diameter of outflow vein>4mm,n=41)and expanded polytetrafluoroethylene(ePT-FE)type of artificial blood vessel group(diameter of outflow vein 3~4mm,n=42).They were followed up for 18 months after the surgery.Postoperative patency rate,effectiveness,complication and survival rate were compared between the two groups.Results The primary patency rates and secondary patency rates after the surgery for 6,12 and 18 months had no statistical significances between promptly used type group and ePTFE type group(Primary patency rate:t=1.437,0.609 and 0.595 respectively;P=0.231,0.435 and 0.441 respectively.Secondary patency rate:t=2.108,0.149 and 0.310 respectively;P=0.147,0.699 and 0.578 respectively).The time of first puncture and the time of dialysis catheter removal after the surgery were shorter in promptly used type group than in ePTFE type group(t=78.386 and 21.491,P<0.001).Postoperative dialysis blood flow and artificial vessel utilization rate were similar between the two groups(t/χ^(2)=0.214 and 0.988,P=0.831 and 0.320).The incidence of postoperative swelling and thrombosis were lower in promptly used type group than in ePTFE type group(χ^(2)=24.418 and 7.540,P<0.001 and 0.006).The survival rates of the patients after the surgery for 6,12 and 18 months had no statistical significances between the two groups(χ^(2)=1.037,0.239 and 0.183 respectively;P=0.309,0.625 and 0.668 respectively).Conclusion The promptly used type of artificial blood vessel for vascular access has the advantages of earlier puncture,higher patency rate,and lower risk of complications,and is worthwhile to be wid

关 键 词：血管通路 即穿型人工血管 应用效果 并发症 生存率 

分 类 号：R318.16[医药卫生—生物医学工程]