连续缝合法和降落伞式连续缝合法在前臂自体动静脉内瘘手术中的应用  

Continuous suture and parachute continuous suture in forearm autologous arteriovenous endovascular fistula surgery

作　　者：梁礼汗 陈卫婷[1,2] 王兮 梁一鸣 LIANG Lihan;CHEN Weiting;WANG Xi;LIANG Yiming(The Eight Clinical Med College of Guangzhou University of Chinese Medicine,Foshan 528000,Guangdong,China;Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,Guangdong,China;不详)

机构地区：[1]广州中医药大学第八临床医学院,广东佛山528000 [2]佛山市中医院,广东佛山528000

出　　处：《实用医学杂志》2025年第6期852-858,共7页The Journal of Practical Medicine

基　　金：广东省基础与应用基础研究基金项目(编号:2022A1515220061);2023年佛山市自筹经费类科技创新项目(医学类科技攻关)(编号:2320001006802)。

摘　　要：目的评估连续缝合法和降落伞式连续缝合法在前臂自体动静脉内瘘手术中的应用效果。方法回顾性选取2020年1月至2024年1月期间医院收治的终末期肾病(ESRD)患者209例患者作为观察对象,根据其血管缝合方式将其分为A组(单纯间断缝合法,n=50)、B组[单纯连续(两点)缝合法,n=63]和C组(降落伞式连续缝合法,n=96)。比较各组术后血管吻合时间、手术时间、血流量、血管通畅率、血栓形成率、并发症发生率及生活质量评分。结果C组血管吻合时间、总体手术时间最短,血流量较少(P<0.05),但血管通畅率、血栓形成率及并发症发生率差异无统计学意义(P>0.05)。C组术后血清炎症因子水平降幅最大,生活质量改善效果最显著(P<0.05)。结论连续缝合法和降落伞式连续缝合法能缩短手术时间,降低血清因子水平,提高生活质量,需根据患者个体差异选择最佳方案。Objective To investigate the efficacy of continuous suture and parachute continuous suture in forearm autologous arteriovenous endovascular fistula surgery,and to analyse their effects on postoperative fistula patency rate and complications.Methods 209 patients with end-stage renal disease(ESRD)admitted to our hospital from January,2020 to January,2024 were selected as observation objects,and they were divided into group A(simple intermittent suture,n=50),group B[simple continuous(two-point)suture,n=63]and group C(parachute continuous suture,n=96)The postoperative vascular anastomosis time,operation time,blood flow,vascular patency rate,thrombosis rate,complication rate and quality of life score of each group were compared.Results In group C,the vascular anastomosis time and overall operation time were the shortest,and the blood flow was less(P<0.05),but there was no significant difference in vascular patency rate,thrombosis rate and complication rate(P>0.05).In group C,the level of serum inflammatory factors decreased the most and the quality of life improved the most significantly(P<0.05).Conclusions Continuous suture and parachute suture can shorten the operation time,reduce the level of serum factors and improve the quality of life.The best scheme should be selected according to the individual differences of patients.

关 键 词：血管缝合 前臂自体动静脉内瘘手术 应用效果 瘘管通畅率 并发症 

分 类 号：R615[医药卫生—外科学]