中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (06): 320-322.doi: 10.3969/j.issn.1671-4091.2013.06.00

• 临床研究 • 上一篇    下一篇

动静脉内瘘取栓术后早期使用的临床观察

陈明喆1,陈健2,陈伟3   

  1. 1. 湖北省黄石市中心医院
    2. 湖北黄石市中心医院肾内科
    3. 湖北省黄石市中心医院肾内科
  • 收稿日期:2012-08-30 修回日期:2012-11-04 出版日期:2013-06-12 发布日期:2013-07-01
  • 通讯作者: 陈明喆 E-mail:cmz_407@126.com

Clinical observation of the early application of the native arteriovenous fistula after removed thrombus operation

  • Received:2012-08-30 Revised:2012-11-04 Online:2013-06-12 Published:2013-07-01

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摘要： 目的 观察动静脉内瘘原位取栓手术后早期使用的临床效果。方法 选取动静脉内瘘成熟并使用后发生血栓栓塞的维持性血液透析患者50例，随机分为对照组（n=25）和实验组（n=25），两组均行原位取栓术和内瘘吻合术，对照组在手术1月后使用内瘘，而实验组在术后1周内即开始使用内瘘，比较两组内瘘1年内的血流量、使用时间以及出现的并发症。结果 （1）两组患者的动静脉内瘘在术后1个月、3个月、6个月、12个月的血流量，均达到235ml/min及以上，两组间无明显差异（P★>0.05）；(2)两组患者的内瘘使用时间均超过了1年；（3）对照组出现8例动脉瘤、9例吻合口狭窄，实验组出现2例动脉瘤、3例吻合口狭窄，两组比较有明显差异（P▼0.05）；两组均未出现血管阻塞。结论 动静脉内瘘原位取栓术后的早期使用是安全、有效的，同时可减少并发症的出现，尽早使用内瘘可以减轻患者的痛苦和经济负担。

关键词: 动静脉内瘘, 维持性血液透析, 血栓形成

Abstract: Objective To observe the effects of early application of the native arteriovenous fistula(AVF) after removed thrombus operation. Methods 50 maintenance hemodialysis patients were randomly divided into two groups, whose AVF were mature and suffered from obstruction after been applicated. ALL of them received removed thrombus operation and anastomosis. The observation group 25 cases used AVF 1 month later, while the control group 25 cases used AVF within 1 week. The blood flux, using time, and relative complications were compared. Results (1)The blood fulx of all AVFs maintained or overed 235ml/min after using 1 month, 3 month, 6 month and 12 month, and there were no statistical differences between both groups. (2)The using time of AVFs overed 1 year in the two groups. (3)8 cases occurred aneurysm, 9 cases occurred stenosis of AVF in control group, while 2 cases occurred aneurysm, 3 cases occurred stenosis of AVF in observation group. There were obviously statistical differences between both groups. 7 cases occurred hypodermal hematoma in control group, while 5 cases occurred in observation. There were no statistical differences between both groups. No vein embolism wer in two groups. Conclusion The early application of the AVF after removed thrombus operation is safety and effective, and can induce the incidence of complication. Early application of the AVF can lighten patients’ pains and economical burdens.

Key words: Arteriovenous fistula, Maintenance hemodialysis, Thrombosis

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