CAJ | 학술논문

目的探讨前臂远端贵要静脉转位建立自体血管内瘘的方法.方法自2007年12月至2009年12月我们对26例维持性血液透析患者进行前臂远端贵要静脉转位建立自体血管内瘘手术治疗.26例中有17例为原桡动脉-头静脉内瘘因并发症失去功能,9例初次行血管内瘘手术.手术方式采用贵要静脉转位与肱动脉端侧吻合;贵要静脉转位与桡-动脉端端吻合;贵要动脉与尺动脉端侧或端端吻合,吻合口直径为5.0～8.0 mm.结果 26例患者中有1例因术后血肿压迫闭塞,2例因术后内瘘成熟不良,其余手术患者一次取得成功,术后血流量达200～350 ml/min.对患者的心功能未造成不良影响,也未出现严重并发症.结论只要适应证选择合适,前臂远端贵要静脉转位建立自体血管内瘘手术,是尽量利用自身血管条件,建立内瘘的一种行之有效的方法.
목적 탐토전비원단귀요정맥전위건립자체혈관내루적방법.방법 자2007년12월지2009년12월아문대26례유지성혈액투석환자진행전비원단귀요정맥전위건립자체혈관내루수술치료.26례중유17례위원뇨동맥-두정맥내루인병발증실거공능,9례초차행혈관내루수술.수술방식채용귀요정맥전위여굉동맥단측문합;귀요정맥전위여뇨-동맥단단문합;귀요동맥여척동맥단측혹단단문합,문합구직경위5.0～8.0 mm.결과 26례환자중유1례인술후혈종압박폐새,2례인술후내루성숙불량,기여수술환자일차취득성공,술후혈류량체200～350 ml/min.대환자적심공능미조성불량영향,야미출현엄중병발증.결론 지요괄응증선택합괄,전비원단귀요정맥전위건립자체혈관내루수술,시진량이용자신혈관조건,건립내루적일충행지유효적방법.
Objiective To investigate surgically created the distal basilic vein transposition arteriovenous fistulas for hemodialysis access.Methods The study reviewed consecutive patients in whom distal basilic vein transposition arteriovenous fistulas were created from December 2007 to December 2009.The basilic vein was anastomosed to the ulnar artery or was transposed and anastomosed to the radial artery or to the brachial artery.Results AVF creation was successful in 23 patients (86.7%).The blood flow were reached 200～350ml/min after operation.There are no any side significant affects on cardiac function.Conclusi ons AVFs utilizing the forearm basilic vein can be considered for primary or secondary vascular access because of the acceptable survival rate and low incidence of hand ischemia.Transposition of the basilic vein is a valuable option in the reconstruction of a thrombosed or stenosed radial-cephalic fistula.