血液透析用鼻烟窝动静脉内瘘28例

The snuffbox arteriovenous fistula for vascular access:28 cases report

目的探讨血液透析鼻烟窝动静脉内瘘的制作方法、通畅率、并发症及临床应用效果。方法 2007年7月以来,对28例慢性肾功能衰竭者在腕关节以远的解剖"鼻烟窝"部建立动静脉内瘘,采用头静脉与桡动脉的背侧支端侧吻合,6周后用于临床血液透析。结果 28例均为首次行内瘘术,术中即刻通畅率100%。3例术后近期内因血管闭塞,2例因流量不足在腕部行标准动静脉内瘘术。28例患者得到术后随访,随访时间2月至4年。透析后1年通畅率为75%,使用良好,并发症少。结论鼻烟窝动静脉内瘘扩大了可穿刺范围,保护了近端血管,可成为血管条件良好的长期血透患者的首选血液透析通路。

Objective To determine the establishment, patency rate , complication and applicability of internal arteriovenous fistula at anatomical snuff - box. Methods Twenty - eight chronic renalfailure patients have been established internal arteriovenous fistula at anatomical snuff - box below the carpal joint since July, 2007, end - to - side anastomosis between cephalic vein and the dorsal branch of arteria radialis, for clinical hemodialysis 6 weeks later. Results Twenty - eight patients were all operated for first time, the instant pantency rate during the operation was 100%. 3 patients were operated again on standard side for vascular occlusion, and 2 patients for insufficient blood flow during hemodialysis 6 weeks later. 28 patients had the follow - up after operation from 2 months to 4 years. The fistula worked well with less complications, 1 year pantency is 75%. Conclusion The snuffbox AV fistula enlarges the puncture range, and preserves the proximal vessels. It can be the first choice of blood access for chronic hemodialysis patients who have good vessel condition.