中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (10): 733-735.doi: 10.3969/j.issn.1671-4091.2014.10.014

• 血管通路 • 上一篇    下一篇

静脉造影评估上肢动静脉内瘘成形术前静脉血管的价值

刘池拽,师天雄,胡锡祥,缪健航,王折存   

  1. 广东中山市人民医院(中山大学附属中山医院)血管外科
  • 收稿日期:2014-04-08 修回日期:2014-07-27 出版日期:2014-10-12 发布日期:2014-10-21
  • 通讯作者: 刘池拽 zhuaizhuai_2001@sina.com E-mail:zhuaizhuai_2001@sina.com

Preoperative venography for evaluating upper limb veins in patients before arteriovenous fistula surgery

  • Received:2014-04-08 Revised:2014-07-27 Online:2014-10-12 Published:2014-10-21

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摘要： 目的探讨上肢静脉造影在评估拟行上肢动静脉内瘘患者静脉的价值。方法对中山大学附属中山医院血管外科2012 年6 月～2014 年1 月行动静脉内瘘术的89 例尿毒症患者中21 例行上肢静脉造影，根据术前上肢静脉造影结果选择目标血管后，行动静内瘘成形术，术后常规予以扩血管、抗血小板治疗。结果所有21 例患者均顺利完成检查，共发现36 条适合建立内瘘的静脉。4 例行前臂动静脉内瘘成形术，手术成功率100%，1 期内瘘通畅率100%，8 例行肘窝动静脉内瘘成形术，手术成功率100%，1 期内瘘通畅率100%，9 例行人工血管动静脉内瘘，手术成功率100%，1 期内瘘通畅率100%。结论上肢静脉造影在术前评估行动静内瘘成形术的静脉是非常有价值的方法，可发现临床上比较隐蔽的可适合的静脉，值得临床应用。

关键词: 动静脉内瘘, 静脉造影, 静脉, 评估

Abstract: Objective To study the value of preoperative venographic mapping in patients who require arteriovenous fistulas. Methods From June 2012 to Jan. 2014, venography was performed in 21 uremia cases. Arteriovenous fistula was then created based on the venography image. Vasodilators and anti-platelet therapy were administered postoperatively. Results Arteriovenous fistulas were successfully accomplished in the 21 cases. A total of 36 veins were found to be suitable for arteriovenous fistula. In the 21 cases, 4 forearm arteriovenous fistulas, 8 elbow arteriovenous fistulas, and 9 arteriovenous fistula grafts were created with surgical success rate of 100% and primary patency rate of 100%. Conclusion Venography is a useful tool for venous mapping prior to vascular access surgery. It can identify clinically occult veins usable for hemodialysis access, and is worthy of clinical application.

Key words: arteriovenous fistulas, venography, veins, evaluation