| 摘要: |
| 目的 评估机能性端侧吻合与传统端侧吻合两种不同吻合术对血液透析患者动静脉内瘘成形术的手术成功率及瘘管通畅率,总结治疗经验,以期进一步提高手术效果。方法 124例慢性肾衰需长期血液透析的患者被随机分为2组,分别采用机能性端侧吻合(n=63)与传统端侧吻合(n=61)进行动静脉内瘘成形术,比较两种吻合术对手术成功率及瘘管通畅率的影响并作统计学分析。结果 机能性端侧吻合组平均吻合时间为(20.4±5.6) min,传统端侧吻合组为(26.2±5.2) min,两组吻合时间差异有统计学意义(P<0.05) 。机能性端侧吻合组患者术后1个月、6个月和1年通畅率分别为93.6%、87.3%、76.2%,与传统端侧吻合组(术后1个月、6个月和1年通畅率分别为95.1%、82.0%、72.1%) 比较差异无统计学意义。结论 对于长期血透患者,采用机能性端侧吻合建立动静脉瘘的近远期通畅率与传统端侧吻合无明显差异,但机能性端侧吻合建立动静脉内瘘制作更简便,手术时间更短,而且方便二次手术探查和取栓,更易被患者及家属所接受。 |
| 关键词: 血液透析 动静脉瘘 吻合术 |
| DOI：10.3724/SP.J.1008.2010.01065 |
| 投稿时间：2010-06-10修订日期：2010-09-21 |
| 基金项目: |
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| Functional and traditional end-to-side anastomosis for arteriovenous fistula plasty in |
| GUAN Sheng, DUAN Yong-liang, LIU Xiao-qing, ZHANG Hong-yuan,BAO Wen* |
| (Department of Vascular Surgery,the Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi 830000,Xinjiang, China) |
| Abstract: |
| Objective To evaluate the success rate and potency rate of functional and traditional end-to-side anastomosis for radial artery-cephalic vein arteriovenous fistula in hemodialysis patients, so as to summarize our experience and to improve the operation outcomes.Methods Totally 124 patients with chronic renal failure receiving radial artery-cephalic vein arteriovenous shunt for hemodialysis were randomly divided into 2 groups, namely, the functional end-side anastomosis and the traditional end-side anastomosis. The successful rate and year patency rate of the two methods were compared and analyzed.Results The mean operation time periods for functional and traditional end-side anastomosis were (20.4±5.6) min and (26.2±5.2) min, respectively(P<0.05) . The 1-month, 6-month, and 12-month patency rates were 93.6%, 87.3%, and 76.2%, in the functional end-side anastomosis group, and 95.1% (P>0.05), 82.0%(P>0.05) ,72.1%(P>0.05) in the traditional end-side anastomosis group, respectively, with no significant differences found in the three rates between the two groups.Conclusion The short-term and long-term patency rates are similar between hemodialysis patients undergoing functional and traditional end-to-side anastomosis for radial artery-cephalic vein arteriovenous fistula. The functional end-side anastomosis is more convenient and needs a shorter time, and it also makes it easy for a second surgical exploration. |
| Key words: hemodialysis arteroivenous fistula anastomosis |
