经颈部静脉旁路术治疗锁骨下静脉闭塞所致透析内瘘失功  

Transjugular vein bypass for the treatment of hemodialysis arteriovenous fistula dysfunction caused by subclavian vein occlusion

作　　者：何兰兰 杨轲 任万军 王小平 HE Lanlan;YANG Ke;REN Wanjun;WANG Xiaoping(School of Clinical Medicine,Shandong Second Medical University,Weifang 261053,Shandong,China;Department of Nephrology,Pingyu County People's Hospital,Pingyu 463400,Henan,China;Department of Nephrology,Central Hospital Affiliated to Shandong First Medical University,Jinan 250013,Shandong,China)

机构地区：[1]山东第二医科大学临床医学院,山东潍坊261053 [2]平舆县人民医院肾内科,河南平舆463400 [3]山东第一医科大学附属中心医院肾内科,山东济南250013

出　　处：《山东大学学报（医学版）》2024年第6期91-95,共5页Journal of Shandong University:Health Sciences

摘　　要：目的探讨经颈部静脉旁路术治疗血液透析血管通路相关锁骨下静脉闭塞的临床效果。方法回顾性分析3例锁骨下静脉闭塞所致透析内瘘失功患者的临床特点、经颈部静脉旁路术的要点及术后内瘘功能状况。结果3例患者经颈部静脉旁路术均取得成功,术后均未出现相关并发症。病例1术后随访9个月,转位血管通畅,内瘘功能良好;病例2术后随访33个月,两次因吻合口狭窄行PTA治疗,现人工血管通畅,内瘘功能良好;病例3术后随访15个月,人工血管通畅,内瘘功能良好。结论锁骨下静脉闭塞经腔内治疗等措施无法成功或风险较大时,颈部静脉旁路术可以作为一种选择。Objective To investigate the clinical effect of transjugular vein bypass for the treatment of hemodialysis arteriovenous fistula dysfunction caused by subclavian vein occlusion.Methods Clinical characteristics,key points of transjugular venous bypass,and postoperative fistula function of three cases with hemodialysis arteriovenous fistula dysfunction caused by subclavian vein occlusion were retrospectively analyzed.Results Transjugular venous bypass was successful in all three patients,and none of them had any related postoperative complications.Patient 1 was followed up for 9 months postoperatively,with a patent transposition vessel and good arteriovenous fistula function.Patient 2 was followed for 33 months postoperatively,with PTA twice for anastomotic stenosis;the artificial blood vessel was patency and the arteriovenous fistula function was good.Patient 3 was followed up for 15 months postoperatively,with a patent artificial blood vessel and good arteriovenous fistula function.Conclusion Transjugular venous bypass can be an option when endovascular treatment for subclavian vein occlusion is unsuccessful or risky.

关 键 词：血液透析 动静脉内瘘 中心静脉狭窄 锁骨下静脉闭塞 解剖外旁路术 

分 类 号：R459.5[医药卫生—治疗学]