目的 探讨改良动静脉吻合及扩张头静脉对终末期肾功能衰竭血液透析患者细小血管内瘘成熟的影响.方法 选取2014年1月至2022年4月连州市人民医院肾内科收治的43例前臂细小血管的维持性血液透析患者作研究对象,按随机数字表法分成观察组(n=21)和对照组(n=22),观察组采用改良动静脉吻合及扩张头静脉的手术方法建立内瘘,对照组则采用传统内瘘手术方法,比较两组患者首次使用内瘘时头静脉直径、桡动脉流速、内瘘血流量、首次使用内瘘时间,以及两组的手术成功率、内瘘成熟率、术后1个月及1年的通畅率.结果 观察组的头静脉直径大于对照组,桡动脉流速、内瘘流量高于对照组,首次使用内瘘时间短于对照组,差异有统计学意义(P＜0.05);观察组的内瘘手术成功率、成熟率、术后1个月及1年通畅率均高于对照组,差异有统计学意义(P＜0.05).结论 改良动静脉吻合及扩张头静脉的手术方式有利于提高前臂细小血管内瘘手术成功率、成熟率和通畅率,值得在临床上推广应用.
Objective To investigate the effect of improved arteriovenous anastomosis and cephalic vein dilation on the maturation of small intravascular fistula in end-stage renal failure hemodialysis patients.Methods A total of 43 mainte-nance hemodialysis patients with small forearm vessels admitted to the Department of Nephrology,Lianzhou People's Hospi-tal from January 2014 to April 2022 were selected as the research objects,and they were divided into observation group(n=21)and control group(n=22)by random number table method.The observation group was treated with improved arteri-ovenous anastomosis and cephalic vein dilation to establish internal fistula,while the control group was treated with tradi-tional internal fistula surgery.The diameter of cephalic vein,radial artery flow velocity,blood flow of internal fistula,the time of first use of internal fistula,the success rate of operation,the maturity rate of internal fistula,and the patency rate of 1 month and 1 year after operation were compared between the two groups.Results The diameter of cephalic vein in the ob-servation group was larger than that in the control group,the flow velocity of radial artery and the flow rate of internal fistula were higher than those in the control group,and the time of first use of internal fistula was shorter than that in the control group,and the differences were statistically significant(P＜0.05).The success rate of fistula operation,maturity rate,patency rate of 1 month and 1 year after operation in the observation group were higher than those in the control group,and the dif-ferences were statistically significant(P＜0.05).Conclusion The improved surgical method of arteriovenous anastomosis and cephalic vein expansion is beneficial to improve the success rate,maturity rate and patency rate of forearm small vascu-lar internal fistula surgery,which is worthy of clinical application.
彭卫平;杨文早;欧阳奋竞;朱建强;罗红梅
广东省连州市人民医院肾内科,广东连州 513400
临床医学
血液透析;改良动静脉吻合;细小血管;头静脉直径;内瘘血流量;内瘘成熟
Hemodialysis;Improved arteriovenous anastomosis;Small blood vessels;Cephalic vein diameter;Internal fis-tula blood flow;Maturation of internal fistula
《中国当代医药》 2024 (001)
51-54 / 4
评论