建立动静脉内瘘直接缝合法与钛轮钉吻合法的对比研究

Clinical study of arterio-venous fistula on diabetic nephropathy patients

目的探讨不同内瘘制作方法对糖尿病肾病患者行动静脉内瘘的优势。方法总结本院2000-2006年对糖尿病肾病患者施行的内瘘手术64例，分别采用直接缝合法行端侧吻合制作内瘘和钛轮钉端吻合建立动静脉内瘘。比较两种类型内瘘的成功率和并发症发生率。结果直接缝合法行内瘘成功率高，并发症少，2年内瘘通畅率达93．8％；钛轮钉端吻合建立的动静脉内瘘为71，9％。结论在糖尿病肾病患者中用直接缝合法行内瘘效果好，可以作为糖尿病肾病患者建立血管通路的首选方式。

Objective To explore the advantage between End-slde anastomosis and titanium nail therapy for diabetic nephropathy patients in establishing arterio-venous fistula. Methods Retrospective summation of the successful rate and complications in 64 arterio-venous fistula with diabetic nephropathy from 2000 to 2006 was made,there were 32 fistula of End-side anastomosis,and 32 fistula of titanium nail therapy. Results In End-slde anastomosis group,93, 8% arterio-venous fistula utility time was over 2 years; titanium nail therapy 71.9% , which was significantly longer than in titanium nail group. In End-side anastomosis group, the incidences of complications were lower than in titanium nail group. Conclusion End-side anastomosis is the first choice for arterio-venous fistula on diabetic nephropathy patients.