复杂动静脉内瘘手术体会

Surgery Experience of Complex Arteriovenous Fistula

目的探讨建立复杂动静脉内瘘的方法和体会。方法在肘上选择肱动脉-肘正中静脉、贵要静脉、头静脉端侧吻合,贵要静脉-尺动脉、桡动脉端侧吻合建立动静脉内瘘供透析使用。结果 28例内瘘术后通畅均良好,血流量可达300 mL/min。其中:17例仍在继续使用,2例因瘘闭改为深静脉置管,4例因肾移植而中断透析,3例因肺部感染死亡,2例死于脑出血。结论根据患者的血管条件,"精工细做"建立动静脉内瘘维持透析,效果满意。

Objective To investigate the complex arteriovenous fistula of the methods and experience. Methods The brachial artery in the elbow-the median cubital vein,basilic vein,cephalic vein end to side anastomosis,basilic vein-the ulnar artery and radial artery end to side anastomosis to the establishment of arteriovenous fistula for dialysis use. Results 28 cases of fistula patency were good,the blood flow of up to 300 mL/min,of which 17 cases still continue to use.2 cases due to fistula closure into a deep vein catheter,and 4 cases of renal transplantation and interrupt dialysis,3 cases of death due to lung infection,died of cerebral hemorrhage in 2 cases. Conclusion According to the patient′s vascular condition with fine work,the establishment of the arteriovenous fistula to maintain dialysis has satisfactory effect.