中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
14期
59-61
,共3页
陈元庄%胡女元%马滚韶%冼翠华
陳元莊%鬍女元%馬滾韶%冼翠華
진원장%호녀원%마곤소%승취화
人工血管%血管通路%动静脉内瘘%血液透析
人工血管%血管通路%動靜脈內瘺%血液透析
인공혈관%혈관통로%동정맥내루%혈액투석
Artificial vessel%Vascular access%Arteriovenous fistula%Hemodialysis
目的 评价以人工血管移植建立尿毒症患者前臂永久性血管通路的临床应用价值.方法 自2008年2月至2012年2月46例尿毒症患者以膨体聚四氟乙烯(e-PTFE)人工血管行前臂动静脉内瘘术,并对其术后内瘘的应用情况进行临床分析.结果 手术均成功建立内瘘,l例术后2周死于消化道出血,2例内瘘应用1个月后死于心力衰竭,其他43例均获随访3 ～42个月,能满足每周2～3次的血液透析,临床应用有效率为93.5％.4例应用9 ～12个月后因内瘘栓塞而改行腹透,5例行2次人工血管内瘘术,其中内瘘栓塞3例、锁骨下静脉栓塞1例、假性动脉瘤l例.结论 在尿毒症患者前臂浅静脉条件欠佳而难以建立自体动静脉内瘘时,以人工血管移植能有效地建立起满足血透要求的内瘘,是建立永久性血管通路的较好选择.
目的 評價以人工血管移植建立尿毒癥患者前臂永久性血管通路的臨床應用價值.方法 自2008年2月至2012年2月46例尿毒癥患者以膨體聚四氟乙烯(e-PTFE)人工血管行前臂動靜脈內瘺術,併對其術後內瘺的應用情況進行臨床分析.結果 手術均成功建立內瘺,l例術後2週死于消化道齣血,2例內瘺應用1箇月後死于心力衰竭,其他43例均穫隨訪3 ～42箇月,能滿足每週2～3次的血液透析,臨床應用有效率為93.5％.4例應用9 ～12箇月後因內瘺栓塞而改行腹透,5例行2次人工血管內瘺術,其中內瘺栓塞3例、鎖骨下靜脈栓塞1例、假性動脈瘤l例.結論 在尿毒癥患者前臂淺靜脈條件欠佳而難以建立自體動靜脈內瘺時,以人工血管移植能有效地建立起滿足血透要求的內瘺,是建立永久性血管通路的較好選擇.
목적 평개이인공혈관이식건립뇨독증환자전비영구성혈관통로적림상응용개치.방법 자2008년2월지2012년2월46례뇨독증환자이팽체취사불을희(e-PTFE)인공혈관행전비동정맥내루술,병대기술후내루적응용정황진행림상분석.결과 수술균성공건립내루,l례술후2주사우소화도출혈,2례내루응용1개월후사우심력쇠갈,기타43례균획수방3 ～42개월,능만족매주2～3차적혈액투석,림상응용유효솔위93.5％.4례응용9 ～12개월후인내루전새이개행복투,5례행2차인공혈관내루술,기중내루전새3례、쇄골하정맥전새1례、가성동맥류l례.결론 재뇨독증환자전비천정맥조건흠가이난이건립자체동정맥내루시,이인공혈관이식능유효지건립기만족혈투요구적내루,시건립영구성혈관통로적교호선택.
Objective To evaluate the clinical application of permanent vascular access in urinemic patients by artificial vessel graft in forearm.Methods From February 2008 to February 2012,46 urinemic patients underwent e-PTFE artificial vessel graft in forearms as a permanent vascular access for hemodialysis.The clinical applications of the accesses were analyzed after operations.Results All the operations could establish the arteriovenous fistulas successfully.One case died of alimentary canal hemorrhage two weeks after the operation,2 cases died of heart failure one month after the application of artificial vessel fistula.The other 43 cases were followed up for 3-42 months.The fistulas could meet the demands of hemodialysis 2-3 times each week.The effective rate was 93.5％ for clinical application.But 9-12 months after the application,4 cases changed to peritoneal dialysis because of the embolisms.Five cases performed the second arteriovenous fistulas,the reasons included embolisms in 3 cases,subclavian vein embolism in 1 case,and false aneurysm in 1 case.Conclusions When the vessels in urinemic patients are too bad to perform arteriovenous fistulas,the artificial vessel grafts can do this effectively for the demands of hemodialysis.It provides a good choice for establishing the permanent vascular-access.
