中国血液净化

中国血液净化 ›› 2018, Vol. 17 ›› Issue (06): 405-406.doi: 10.3969/j.issn.1671-4091.2018.06.011

• 血管通路 • 上一篇    下一篇

6F 导尿管在自体动静脉内瘘术中的应用

徐大宇1,2,孔祥雷1,刘燕3,张磊1,许冬梅1   

  1. 1山东大学附属千佛山医院肾脏内科
    2淄博市中心医院肾脏内科
    3山东大学附属千佛山医院手术室
  • 收稿日期:2017-04-25 修回日期:2018-03-22 出版日期:2018-06-12 发布日期:2018-06-20
  • 通讯作者: 许冬梅 xudongmei63@163.com E-mail:xudongmei63@tom.com

Application of 6F urinary catheter in the autogenous arteriovenous fistula operation

  • Received:2017-04-25 Revised:2018-03-22 Online:2018-06-12 Published:2018-06-20

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摘要： 【摘要】目的评价6F 导尿管在自体动静脉内瘘术(arteriovenous fistula,AVF)中的应用价值。方法选取2016 年10 月～2017 年3 月在山东大学附属千佛山医院肾脏内科行AVF 手术并应用6F 导尿管的患者为研究对象，包括38 例AVF 内瘘闭塞重建术(A 组)及20 例初次手术者(B 组)。初次手术者结扎头静脉远心端后，从静脉断端向近心端送入6F 导尿管后，向导尿管尖端球囊注入0.3～0.5ml 生理盐水，可重复扩张；AVF 重建者，向导尿管尖端球囊注入0.5～0.8ml 生理盐水(根据静脉内径调整用量)，有新鲜血栓时，可将血栓一并取出，如遇狭窄，可再次导入尿管重复扩张静脉并在狭窄部位停留10s 以上并加大球囊注水量。结果A 组38 例AVF 重建术患者内瘘再通率达100%，B 组20 例患者扩张前后内径差异显著，有统计学意义(t=3.552，P＜0.001)。结论6F 导尿管在AVF 术中应用方便，对细小静脉扩张效果好，对轻度狭窄病变可利用尖端球囊进行扩张，也可应用于部分取栓病例，值得临床推广应用。

关键词: 动静脉内瘘, 导尿管, 血液透析

Abstract: 【Abstract】Objective To evaluate the 6F urinary catheter used in the autogenous arteriovenous fistula (AVF) surgery. Methods Patients who used 6F urinary catheter during AVF surgery in the Department of Nephrology, Qianfoshan Hospital Affiliated to Shandong University from October 2016 to March 2017 were recruited. Thirty-eight cases underwent AVF reconstruction (group A), and twenty cases had primary AVF surgery (group B). During primary AVF surgery, the distal end of the cephalic vein was ligated and a 6F urinary catheter was inserted from the venous stump to proximal end and 0.3～0.5 ml of normal saline was injected into the balloon at the tip of the catheter to repeatedly expand the vessel. During AVF reconstruction surgery, a 6F urinary catheter was inserted into the proximal end of the vein, and 0.5～0.8ml of normal saline was injected into the balloon at the tip of the catheter. The normal saline volume may be adjusted according to the venous diameter. Fresh thrombus can be taken out. In case of stenosis, the catheter can be reintroduced into the vein and indwelled in the stenosis site for more than 10 seconds, and the volume of normal saline may be increased. Results In group A, the rate of internal fistula recanalization was 100%. In group B, the diameters of the vessel before and after expansion were significant different (t=3.552, P＜0.001). Conclusion The use of 6F urinary catheter during AVF surgery was convenient and especially effective for the expansion of small veins. The tip balloon of the catheter can be used for dilatation of mild stenosis lesion and also for thrombectomy in some cases. This method is worthwhile to be widely used in clinical practice

Key words: Arteriovenous fistula, urinary catheter, hemodialysis