摘要
目的分析三种自体动静脉内瘘手术方式差异，对比其临床特点和并发症情况，为内瘘手术方式选择提供参考。方法72例手术患者，根据手术方式的不同分为前臂内瘘手术组、鼻烟窝内瘘手术组和肘关节内瘘手术组，分别进行手术，观察手术持续时间、内瘘成熟时间、并发症发生情况、术后第8周内瘘大小、血流量、内瘘静脉直径、对心功能影响等指标。结果三种手术方式手术持续时间无显著性差异(P>0.05)，内瘘成熟时间差异有统计学意义(F=36.423，P=0.000)，在并发症发生、第8周内瘘口大小、血流量、静脉直径及对心脏功能影响方面差异无统计学意义(P>0.05)。结论根据患者临床特点、血管情况进行内瘘手术方式的选择可实现动静脉内瘘的最优化建立。
Abstract
Objective To analyze the differences、clinical characters and complications of three types of autogenous arteriovenous(AV) fistulas for hemodialysis, so as to provide guidance foroperation methods and their clinical application to hemodialysis. Methods 72 patients undergoing autogenous AV fistula procedures were divided into wrist AV fistula group(48 cases), snuf-box AVfistula group(14 cases) and elbow AV fistula group(10 cases) accordingto color doppler Ultrasonographic evaluation before operation. The operation time, mature time of AVF, complication data and diameter of AVF, blood flow for hemodialysis, venous diameter and influence on cardiac functionwere recorded. Results Operation time of the three types of operation showed no statistic difference(P>0.05). there is statistic difference in AVF mature time(F=36.423,P=0.000); The differences of complications data, diameter of AVF, blood flow for hemodialysis, venous diameter and influence on cardiac function in the three groups is not significant(P>0.05). Conclusion Color Doppler Ultrasonographic evaluation and clinical characters can provide optimal choice for AVF operation. Snuf-box AV fistula can be the first choice for patients with satisfactory vascular access, while elbow AV istula can be used for those with poor vascular access or with forearm fistula failure.
NETL
NSTL
维普
万方数据