摘要
[目的]探讨建立血液透析（HD）通路的时机及提高手术成功率和远期通畅率的影响因素.[方法]回顾性分析296例尿毒症患者（321次）动静脉内瘘建立的情况.[结果]上肢自体动静脉内瘘（AVF）一期成功率96.51%,而肘部、下肢自体AVF及人工血管AVF术为100%.人工血管AVF较自体AVF成熟时间短（P〈0.05）.鼻烟窝及人工血管内瘘较易发生血栓形成（P〈0.05）;而端-侧吻合较少（P〈0.05）;肘窝、下肢自体AVF及人工血管AVF内瘘易成熟（P〈0.05）.[结论]腕部头静脉-桡动脉端-侧吻合（标准内瘘）是首选;改良侧-侧吻合对血管条件好的患者亦有较高成功率;人工血管内瘘为自体内瘘失败者提供了更多的选择.
[Objective] To explore the time of the establishment of hemodialysis access, and the factors for improving success rate of surgery and long-term patency rate. [Methods]A total of 296 uremia patients who established hemodialysis access were analyzed retrospectively. [Results] The one-stage successful rate of au- tologous arteriovenous fistula（AVF） in upper extremity was 96.51%, and the successful rate of AVF in cubital fossa and lower extremity and artificial blood vessel arteriovenous fistula was 100%. The maturation time of artificial vessel AVF was shorter than that of autologous AVF（ P 〈0.05）. Compared to other parts of fistula thrombosis, snuffbox fistula and artificial blood vessels had high incidence（ P〈0.05）. But the incidence of thrombosis of end-side anastomosis was lower（ P 〈0.05）. In the maturation, all the cubital fossa AVF, lower extremity autologous AVF and artificial vessel AVF had obvious advantages（ P 〈0.05）. [Conclusion] The end-side anastomosis of wrist cephalic vein and radial artery （standard fistula） is first choice. Modified side-side anastomosis for patients with good vascular conditions has relatively high successful rate. Artificial vessel AVF provides more good options for patients whose autologous fistulas are failure.
出处
《医学临床研究》
CAS
2010年第5期789-791,共3页
Journal of Clinical Research
关键词
动静脉瘘
血液透析
arteriovenous fistula
hemodialysis
