血管移植透析内瘘术—附45例(51人次)报告

Vascular access grafts for hemodialysis in 45 patients (51 times)

本文报告４５例（５１人次）血管移植透析内瘘术。采用自体大隐静脉、异体动脉和人造血管（Ｅ－ＰＴＦＥ）材料，移植瘘管的一年透析使用率为８１．５８％，使用３年以上８例，病人带功能移植瘘管总时间最长达７６个月以上。每１００个移植瘘管随访月平均并发症发生率为３．６２，其中血栓形成和回流静脉或流出端吻合口狭窄是移植瘘管的主要失功原因。作者认为异体动脉具有良好的组织相容性、较高的瘘管使用率和血管材料的相对可选择性。

This study reports autogenous saphenous vein(n=7),human artery allograft(n=41) and expanded PTFE(n=3) grafts for dialysis arteriovenous fistula placed in the forearm in chronic hemodialysis patients.The average primary patency rate of all grafts was 81.58% at the first year,55.3% at the second year,and 27.93% at the third year.The longest secondary graft fistula patency time was 76 months.The incidence of complications in autogenous saphenous vein fistula,human artery allografts and expanded PTFE grafts was 2.91,2.9 and 11.76 per 100 graft-months of follow-up respectively.Stenosis at the graft-saphenous vein,thrombosis and stenosis at the venous outflow tract in human artery allografts were the most common complications leading to graft fistula failure.Infection was found in three expanded PTFE fistulas.Sepsis was suffered by two expanded PTFE graft patients.