中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
22期
56-57
,共2页
桡动脉%血液透析%假性动脉瘤%动静脉内瘘%血管储备
橈動脈%血液透析%假性動脈瘤%動靜脈內瘺%血管儲備
뇨동맥%혈액투석%가성동맥류%동정맥내루%혈관저비
Radial artery%Hemodialysis%Pseudoaneurysm%Internal arteriovenous fistula%Vascular reserve
目的 探求血液透析直穿致腕上桡动脉假性动脉瘤手术的同时,最大程度使用血液透析可用血管一期行动静脉内瘘,从而增加透析可用血管的储备,达到提高患者生存率和生活质量的目的.方法 总结农垦中心医院对133例桡动脉假性动脉瘤患者的治疗经验并进行分析,找出手术最佳方法与疗效的关系,除9例感染性假性动脉瘤瘤体破裂出血抢救患者生命的同时急诊手术,其他均择期手术,106例切除瘤体同时行一期头静脉-桡动脉吻合内瘘成形术.结果 133例中9例瘤体破裂出血休克,急诊手术抢救患者生命,2例抢救无效死亡;106例并一期行内瘘成形术,占手术总数的79.7％;术后平均随访(16.0±0.5)个月,93例内瘘成熟后血流能满足血液透析需要,成功率为87.7％.结论 对血液透析直穿致腕上桡动脉假性动脉瘤治疗不能满足于流体切除加血管重建,大部分患者切除瘤体同时可一期行内瘘成形术,能充分使用血液透析可用血管,成功率较高,是有效可行的方法.
目的 探求血液透析直穿緻腕上橈動脈假性動脈瘤手術的同時,最大程度使用血液透析可用血管一期行動靜脈內瘺,從而增加透析可用血管的儲備,達到提高患者生存率和生活質量的目的.方法 總結農墾中心醫院對133例橈動脈假性動脈瘤患者的治療經驗併進行分析,找齣手術最佳方法與療效的關繫,除9例感染性假性動脈瘤瘤體破裂齣血搶救患者生命的同時急診手術,其他均擇期手術,106例切除瘤體同時行一期頭靜脈-橈動脈吻閤內瘺成形術.結果 133例中9例瘤體破裂齣血休剋,急診手術搶救患者生命,2例搶救無效死亡;106例併一期行內瘺成形術,佔手術總數的79.7％;術後平均隨訪(16.0±0.5)箇月,93例內瘺成熟後血流能滿足血液透析需要,成功率為87.7％.結論 對血液透析直穿緻腕上橈動脈假性動脈瘤治療不能滿足于流體切除加血管重建,大部分患者切除瘤體同時可一期行內瘺成形術,能充分使用血液透析可用血管,成功率較高,是有效可行的方法.
목적 탐구혈액투석직천치완상뇨동맥가성동맥류수술적동시,최대정도사용혈액투석가용혈관일기행동정맥내루,종이증가투석가용혈관적저비,체도제고환자생존솔화생활질량적목적.방법 총결농은중심의원대133례뇨동맥가성동맥류환자적치료경험병진행분석,조출수술최가방법여료효적관계,제9례감염성가성동맥류류체파렬출혈창구환자생명적동시급진수술,기타균택기수술,106례절제류체동시행일기두정맥-뇨동맥문합내루성형술.결과 133례중9례류체파렬출혈휴극,급진수술창구환자생명,2례창구무효사망;106례병일기행내루성형술,점수술총수적79.7％;술후평균수방(16.0±0.5)개월,93례내루성숙후혈류능만족혈액투석수요,성공솔위87.7％.결론 대혈액투석직천치완상뇨동맥가성동맥류치료불능만족우류체절제가혈관중건,대부분환자절제류체동시가일기행내루성형술,능충분사용혈액투석가용혈관,성공솔교고,시유효가행적방법.
Objective To study that at the same time of wrist radial artery pseudoaneurysm surgery induced by direct puncture for hemodialysis,perform one-stage internal arteriovenous fistula with the use of a hemodialysis available vascular at maximum degree,thereby increase available reserves for vascular dialysis,to improve the patients survival and quality of life.Methods The treatment experience of 133 cases of radial artery pseudoaneurysm in our hospital were concluded and analyzed,and the relationship between best surgery method and effect was identified.For 9 infectious radial artery pseudoaneurysm cases with tumor rupture,emergency surgeries were performed at the same time of saving the patient' s life,while for others elective surgeries were performed.For 106 cases,one-stage cephalic vein-radial artery anastomosis fistula angioplasty at in parallel with removal of the tumor was performed.Results In 133 cases,shock occurred in 9 cases due to tumor rupture,emergency surgery was performed to save the patient' s life,two died; fistula angioplasty in parallel was performed in 106 cases,accounting for 79.7％ of the total number of surgeries; the follow-up time was(16.0 ±0.5) months on average,for 93 cases,blood flow can meet the need of hemodialysis after fistula mature,the success rate was 87.7％.Conclusions In treatment of wrist radial artery pseudoaneurysm induced by direct puncture for hemodialysis,we cannot be satisfied with the fluid resection and revascularization,performed one-stage fistula angioplasty in parallel with removal of the tumor can be for most patients to make full use of hemodialysis available vascular,the success rate is high.It is an effective and feasible method.
