摘要
目的探讨贵要静脉移位后,桡动脉-贵要静脉吻合术在老年尿毒症患者的困难内瘘建立中的应用,探索该类患者的动-静脉内瘘建立方法、安全性及可靠性等。方法整群选取该院2013年1月—2016年1月收治的51例长期维持血液透析的高龄患者,采用贵要静脉移位后,行桡动脉-贵要静脉吻合,建立动-静脉内瘘。观察桡动脉-贵要静脉内瘘手术成功率、并发症发生率,使用桡动脉-贵要静脉内瘘透析穿刺成功率及舒适度。结果 51例患者该手术均取得成功。1例术后2 d透析时发生低血压,使用肝素后出现剥离创面出血,其余均无感染、手指及手掌肿胀、缺血性疼痛、前臂及手指等皮肤颜色失常等并发症。术后1月桡动脉-贵要静脉内瘘成熟,成功应用于血液透析中。随访3月桡动脉-贵要静脉内瘘穿刺成功率、舒适度均较高。结论在高龄透析患者的困难内瘘建立中,贵要静脉移位后桡动脉-贵要静脉吻合术具有安全、有效、经济、舒适及术后并发症少等优点。
Objective To discuss the application of radial artery-venae basilica anastomosis in the fistula creation in complicated blood vessel in elderly patients with uremia after venae basilica displacement and explore the creation method, security and reliability of arteriovenous fistula of these patients. Methods 51 cases of elderly patients with long-term maintenance hemodialysis in our hospital from January 2013 to January 2016 were selected, and all patients received radial artery-venae basilica anastomosis after venae basilica displacement thus creating arteriovenous fistulas, the operative success rate of radial artery-venae basilica fistula, incidence rate of complications, success rate and degree of comfort of dialysis and puncture of radial artery-venae basilica fistula were observed. Results The operation of 51 cases was successful,hypopiesia occurred to 1 case at the time of dialysis in postoperative 2d, wound bleeding appeared after the use of heparin,all others had no complications such as infection, finger and palm swelling, ischemic pain, skin color disorders of forearm and finger, after the radial artery-venae basilica fistulas were matured, they were successfully applied in the hemodialysis,and the puncture success rate and degree of comfort of radial artery-venae basilica fistulas were higher after 3-month follow-up. Conclusion For the fistula creation in complicated blood vessel in elderly patients, radial artery-venae basilica anastomosis after venae basilica displacement is safe, effective, economic and comfortable with fewer postoperative complications.
出处
《中外医疗》
2016年第13期81-83,共3页
China & Foreign Medical Treatment
关键词
贵要静脉移位
动-静脉吻合术
尿毒症
困难内瘘建立
Venae basilica displacement
Arteriovenous anastomosis
Uremia
Fistula creation in complicated blood vessel
