摘要
目的探讨前臂腕部两种不同动静脉内瘘吻合术对患者动静脉内瘘近期血流量和1年内栓塞发生情况的影响。方法回顾性分析2020年5月至2022年2月本院收治的81例行前臂腕部动静脉内瘘吻合术患者的临床资料,按照术中不同吻合方式将患者分为端侧组(动静脉内瘘端侧吻合术,41例)和端端组(动静脉内瘘端端吻合术,40例)。比较两组患者的手术指标、内瘘成熟时间、内瘘成熟率、动静脉瘘口直径与内瘘近期血流量以及术后1年内的并发症情况。结果两组患者的血管缝合时间、缝合漏血补针例数以及手术成功率比较,差异均无统计学意义(均P>0.05);端侧组的内瘘成熟时间短于端端组(P<0.05),但两组患者的内瘘成熟率比较,差异无统计学意义(P>0.05);术后4周端侧组的动静脉瘘口直径、内瘘血流量大于端端组,差异均有统计学意义(均P<0.05);端侧组的1年内总栓塞发生率低于端端组(P<0.05),但两组患者的总并发症发生率比较,差异无统计学意义[37.71%(13/41)vs.35.00%(14/40),P>0.05]。结论动静脉内瘘端侧吻合术与动静脉内瘘端端吻合术比较,内瘘易成熟,且动静脉内瘘有较为理想的近期血流量,1年内栓塞发生率低,但以上两种手术吻合方式的整体并发症发生率相似。
Objective To explore the effects of two different types of arteriovenous fistula anastomosis of forearm wrist on the short-term blood flow volume and embolism within 1 year in patients with arteriovenous fistula.Methods The clinical data of 81 patients undergoing arteriovenous fistula anastomosis of forearm wrist in the hospital from May 2020 to February 2022 were retrospectively analyzed.According to different anastomosis methods during surgery,the patients were divided into end-to-side group(arteriovenous fistula end-to-side anastomosis,41 cases)and end-to-end group(arteriovenous fistula end-to-side anastomosis,40 cases).The surgical indicators,fistula maturation time and fistula maturation rate,arteriovenous fistula opening diameter,fistula short-term blood flow volume and complications within 1 year after surgery were compared between the two groups of patients.Results There were no statistical differences in the vascular suture time,the number of stitches for blood leakage and success rate of surgery between the two groups(all P>0.05).The fistula maturation time in end-to-side group was shorter than that in end-to-end group(P<0.05),but there was no statisticalsignificance in the fistula maturation rate between the two groups(P>0.05).Arteriovenous fistula opening diameter and fistula blood flow volume at 4 weeks after surgery in end-to-side group were higher than those in end-to-end group(all P<0.05).The incidence rate of total embolism within 1 year was lower in end-to-side group than that in end-to-end group(P<0.05),but there was no statistical difference in the incidence rate of overall complications between the two groups(P>0.05).Conclusions Compared with arteriovenous fistula end-to-end anastomosis,arteriovenous fistula end-to-side anastomosis has easier fistula maturation,more ideal short-term blood flow volume of arteriovenous fistula and lower incidence rate of embolism within 1 year.However,the above two surgical anastomosis methods have similar incidence rate of overall complications.
作者
吴腾南
吴军
张宏
Wu Tengnan;Wu Jun;Zhang Hong(Department of Nephrology,Anqing First People′s Hospital of Anhui Medical University,Anqing 246000,China)
出处
《国际泌尿系统杂志》
2024年第4期705-708,共4页
International Journal of Urology and Nephrology
关键词
吻合术
外科
前臂
动静脉内瘘
栓塞
Anastomosis,Surgical
Forearm
Arteriovenous Fistula
Embolism
