1256例动静脉内瘘术用于血液透析的临床研究

Clinical study on internal artificial fistula surgery forhemodialysis(report of l256 cases)

自１９８５年１月至１９９６年３月为１２５６例慢性透析患者建立动静脉内瘘术并成功地进行了血液透析。自体血管内瘘１１０１例（鼻烟窝动静脉内瘘５２６例，前臂动静脉内瘘５１２例，上臂动静脉内瘘３６例，下肢动静脉内瘘２７例），大隐静脉搭桥１５例，聚四氟乙烯人造血管（ＰＴＦＥ）搭桥动静脉内瘘１８例，人尸动脉搭桥动静脉内瘘１２２例。手术成功率为１００％，１年的通畅率９５．３％，３年的通畅率８２．５％，５年通畅率７１．２％，１０年通畅率４８．６％。就制作动静脉内瘘以及时国内外开展各种制作内瘘方法的临床评价和经验进行了讨论。

From Jan, 1985 to Mar. 1996,internal arteriovenous fistula(A- V fistula)surgery was performedand chronic hemodialvsis met with success in 1256 cases. In these cases,there were 1101 A- Vfistulas creat- ed at patient,s own vessels(526 at the anatomical snuff-box, 512 in the forearm, 36 in the upper arm,and27 in the lower limb),15 based on great saphenous vein by-pass,18 on blood vessel prosthesis made frompolytetrafluoroethylene and 122 on cadaver artery by- pass. The success rate was 100%. All the patientswere followed up for 1,3,5,or 10 years and the patency rate of the vessels was 95.3%,82.5%,71.2%and48.6%respectively. The author’s experience in creation of A- V fistula is introduced and clinical value ofmethods for creating various A- V fistulas at home and abroad discussed in this paper.