两种内瘘手术方法在维持血液透析患者中的疗效比较

Comparision of Two Kinds of Methods for Making Arterioveneous in Continuous Hemodialysis

目的通过对两种自体动静脉内瘘手术方法在维持血液透析患者的临床应用,探讨维持血液透析患者理想血管瘘的手术方法。方法回顾性分析38例钛制轮钉动静脉内瘘与42例直接缝合动静脉内瘘的临床应用进行比较分析。结果两组比较肽制轮钉动静脉内瘘组的内瘘成熟时间短,平均2～3天,术后2～3天即可用(P<0.01)。两组均无术后感染、出血。但假性动脉瘤形成、血栓形成、吻合口狭窄、心力衰竭,直接缝合组高于肽轮组,但差异无显著性,P>0.05,多因素共同作用后直接缝合组丧失功能(简称失功)明显高于肽轮组,差异有显著性(P<0.05)。结论肽制轮钉动静脉内瘘优于直接血管缝合动静脉内瘘,可运用于各种急慢性病例。

Objective By comparing the two kinds of autologous arterioveneous fistulas for continuous hemodialysis in clinical application, so that to figure out which is the ideal one. Methods We restrospectively investigated 38 patients using the titanium anastomat arteriovenous fistulas and 42 patients using the direct sutured arterioveneous fistulas in the application of continuous hemodialys. Results The group using the titanium anastomat need shorter time for maturation ,2 - 3 days in average ,P〈 0.01 ;2 -3 days after surgery it can be put in use. Both the groups have no infection and hemorrhage. The second group has fewer pseudoaneurysm, thrombosis, stenosis of the anastonesis point and heart failure, but with no significant difference, P 〉 0.05. The second group has a higher rate of dysfunction due to muhifactors, P 〈 0.05, with significant difference. Conclusion Arterioveneous fistula made by titanium anastomat is better than the direct sutured arterioveneous fistula and could be used in acute and chronic patients.