中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (09): 627-630.doi: 10.3969/j.issn.1671-4091.2017.09.012

• 血管通路 • 上一篇    下一篇

286例人工血管动静脉内瘘术临床应用分析

匡斌1,王冕1,连继洪1,邓国三1   

  1. 1. 广东省人民医院(广东省医学科学院)整形周围血管外科
  • 收稿日期:2017-04-24 修回日期:2017-07-02 出版日期:2017-09-12 发布日期:2017-09-12

Polytetrafluoroethylene (PTFE) graft as the fistulas for hemodialysis access: clinical analyses of 286 cases

  • Received:2017-04-24 Revised:2017-07-02 Online:2017-09-12 Published:2017-09-12

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摘要： 目的研究及评价维持性血液透析患者人工血管动静脉内瘘术(arteriovenous graft，AVG)建立血液透析通路的临床应用效果、术后并发症及其处理方式。方法2012 年4 月～2016 年12月间，采用膨体聚四氟乙烯人工血管(ePTFE)移植建立透析血管通路286 例，根据不同患者的肢体血管情况，分别采用合适的血管桥接方式建立血液透析通路，并回顾性分析通畅率和并发症及处理方式。结果手术成功率100%，1 年通畅率95.4%，2 年通畅率88.6%，3 年通畅率为78.4%。常见并发症中狭窄和/或血栓形成占18.5%，假性动脉瘤4.5%，感染3.8%，其他并发症7.0%。经过针对性的处理，可以获得满意的效果。结论人工血管动静脉内瘘术具有口径大、通畅率高、血流量充足、使用时间长和易穿刺等优点，只要我们积极有效的处理术后并发症，不断提高手术成功率和术后通畅率，人工血管动静脉内瘘术必将成为提高血液透析患者生存质量的重要保证。

关键词: 人工血管, 血液透析, 动静脉内瘘

Abstract: Objective To assess the patency and complication of polytetrafluoroethylene (PTFE) graft as the fistulas for hemodialysis access. Methods A total of 286 uremic patients were implanted with expanded PTFE (ePTFE) grafts as the fistulas for permanent hemodialysis access in the period from Apr. 2012 to Dec. 2016. Success rate of fistula surgery, complications, patency rate relating to different surgical sites and different anastomosis forms were retrospectively analyzed. Results Success rate of the operation was l00%. Patency rates at 1, 2 and 3 year were 95.4%, 88.6% and 78.4% respectively. The common complications were
thrombosis (18.5%), pseudoaneurysms (4.5%), infection (3.8%) and others (7.0%). Conclusion ePTFE graft is an ideal alternative for constructing dialysis access in patients with difficulties of direct arteriovenous fistula establishment.

Key words: artificial graft, hemodialysis, arteriovenous fistula