摘要
目的．探讨人造血管动脉脉内瘘（AVF）在血液透析中的临床应用价值。方法回顾性分析北京世纪坛医院血管外科行聚四氟乙烯（胛FE）人造血管内瘘51例的临床资料，并与同期自体动静脉内瘘193例进行比较，分析二组术后并发症发生率、瘘成熟时间、术后干预措施、1年通畅率的差别，结果51例阿FE内瘘均一次手术成功，手术时间2-3h，常见并发症发生率高于自体AVF。PTFE内瘘不成熟发生率为0。低于自体AVF（12例）。PTFE内瘘成熟平均时间（18．0±2．4）d，低于自体AVF成熟时间。PTFE内瘘晚期血栓形成10例，进行溶栓、取栓等干预措施后瘘恢复通畅。1年通畅率：FTFE内瘘85．1％，自体AVF88．8％，结论PTFE内瘩在血液透析中能获得良好效果，其成熟时间短、血流量大、狭窄或闭塞后经溶栓取栓等干预措施后多数能再通，1年通畅率较高。此法尤其适用于自身血管条件差和自体AVF失败的病人，PTFE内瘘和自体AVF二种方法互相补充可获得更长的透析生存时间．
Objective To investigate the value of polytetrafluoroethylene （PTFE） arterovenous grafts （AVG） in bemodialysis. Methods The clinical data of 51 eases of PTFE grafts admitted at Beijing Shijitan Hospital were analyzed retrospectively, which was compared with 193 cases of arterovenous fistula （AVF） simultaneously on the morbidity of complications, time of maturation, postoperative intervention measures and l-year-pentancy rates. Results The operations of PTFE grafts were successful. The operation time is from 2 to 3h. The morbidity of complications of PTFE grafts was higher than that of native AVF. The mobidity of immaturatiou of PTFE grafts （0 case） was lower than that of AVF （12 cases）. The average maturation time of PTFE grafts was 18.0±2.4 days, and it was shorter than that of AVF. There were 10 cases thrombosis in FTFE grafts. After thrombolysis and thrombectomy, the PTFE grafts were patent. One-year-patency rate of PTFE grafts was 85.1%, and that of AVF was 88.8%. Conclusion PTFE grafts has good results in bemodialysis, including the shorter time of maturation, the more blood volume, recurrence of patency after interventions of thromobosis and thrombectomy and the higher l-year-patency. The method applies to the patients with poor vessels and failure of AVF especially. The two methods of PTFE grafts and AVF are dependent so as to achieve longer longevity of hemodialysis.
出处
《中国实用外科杂志》
CSCD
北大核心
2009年第11期918-920,共3页
Chinese Journal of Practical Surgery
关键词
聚四氟乙烯
人造血管动静脉内瘘
血液透析
polytetrafluoroethylene （PTFE）
arterovenous graft （AVG）
hemoditialysis
