摘要
目的:探讨维持性血液透析患者自体动静脉内瘘主要并发症及治疗效果。方法:对319例维持性血液透析患者内瘘手术要点、穿刺方法、主要并发症及治疗方法进行分析。结果:319例内瘘主要在非优势侧前臂行端-端吻合、采用"扣状和绳梯式穿刺法"穿刺。并发症发生率最高的是血栓(26%),主要有吻合口血栓(19.7%)、穿刺部位附壁血栓(6.3%),其次是血管通路狭窄发生率(10.3%)(包括吻合口、静脉解剖本身存在的狭窄、穿刺部位狭窄);第三位是血管瘤,发生率3.8%(主要发生在吻合口及穿刺部位)。319例中234例使用3年以上。结论:造成维持性血液透析患者自体动-静脉内瘘血管通路失功的三个原因,依次是血栓、狭窄、血管瘤。手术治疗仍然是纠正血管通路并发症最有效的治疗方法。
Objective： To explore the procedures for treatment of complications of arteriovenous fistula in patients receiving maintenance hemodialysis. Methods： Three hundred and nineteen patients receiving maintenance hemodialysis were included in the study. The fistula surgery, puncture process, main complications and treatment procedures were analyzed. Results： The arterioveneous fistula in all the 319 case was built mainly by terminal-terminal anastomosis in the unaccustomedly-used forearm with ＂button-like and ladder-type puncture＂. The most common complications were thrombus （ 26% ） including anastomotic thrombosis （ 19. 7% ） and puncture site mural thrombus （6.3%）, vascular access stenosis （ 10.3 % ） including anastomotic stenosis, vein anatomy inherent stenosis and narrow puncture site, and hemangioma which mainly occurred in the stoma and the puncture site（3.8% ）. Of the 319 fistula,234 were used for more than 3 years. Conclusions：The reasons for fistula vascular access dysfunction in maintenance hemodialysis patients are thrombus, stenosis and hemangioma in sequence, and surgery is the most effective therapy for complications of vascular access.
出处
《蚌埠医学院学报》
CAS
2010年第3期273-275,共3页
Journal of Bengbu Medical College
关键词
血液透析
动静脉内瘘
血栓
狭窄
血管瘤
hemodialysis
arterioveneous fistula
thrombus
stenosis
hemangioma
