CAJ | 학술논문

探讨因维持性血液透析行高位动静脉内瘘的手术方法并总结分析其发生并发症的原因及护理方法。方法：回顾性总结我院2010年1月至2012年01月行高位动静脉内瘘术患者，筛选出出现并发症的患者45例，分析、总结其发生原因及护理处理措施。结果：建立前臂自体血管通路困难者施行高位动静脉内瘘术45例，术后早期(7天)未见明显并发症发生；晚期(30天后)出现皮下血肿、假性动脉瘤、充血性心力衰竭、静脉瘤样扩张、静脉迂曲合并血栓形成及吻合口闭塞等并发症，经积极处理后均恢复良好。结论：对于多次前臂动静脉内瘘失败或前臂血管无法利用的患者，在肘上高位建立动静脉内瘘手术安全可靠，是较好的方法，但必须精心护理，以降低并发症的发生风险。
탐토인유지성혈액투석행고위동정맥내루적수술방법병총결분석기발생병발증적원인급호리방법。방법：회고성총결아원2010년1월지2012년01월행고위동정맥내루술환자，사선출출현병발증적환자45례，분석、총결기발생원인급호리처리조시。결과：건립전비자체혈관통로곤난자시행고위동정맥내루술45례，술후조기(7천)미견명현병발증발생；만기(30천후)출현피하혈종、가성동맥류、충혈성심력쇠갈、정맥류양확장、정맥우곡합병혈전형성급문합구폐새등병발증，경적겁처리후균회복량호。결론：대우다차전비동정맥내루실패혹전비혈관무법이용적환자，재주상고위건립동정맥내루수술안전가고，시교호적방법，단필수정심호리，이강저병발증적발생풍험。
Objective To analyze the reasons of complications on hemodialysis cases with elbow arteriovenous fistula,and summarize the treatment to the complications.Methods Retrospective analyze 45 cases with complications of elbow arteriovenous fistula from January 2010 to January 2012, analyze the reasons and summarize the treatment to the complications. Results There was no complications at eraly stage after the surgery(within a week);but later(after a month),there were kinds of complications such as subcutaneous hematoma,pseudoaneur ysm,congestive heart failure,venous ectasia,varicose vein with thrombosis,intimal hyperplasia and occlusion at anastomotic stoma;through appropriate treatment,al the patients recovered wel . Conclusions For those patients with poor vessels or arteriovenous fistula failure at forearm,it is an effective way to make a elbow arteriovenous fistula,but it should be cared intensively to reduce the complications.