改良肘部高位动静脉内瘘术的临床应用

Clinical application of modified elbow high internal arteriovenous fistula

目的 探讨改良肘部高位动静脉内瘘手术方法 以及临床应用效果.方法 回顾性分析本院31例进行改良肘部高位动静脉内瘘吻合术的临床应用效果.结果 自2008年4月～2011年6月笔者共进行肘部远端桡动脉或尺动脉与肘正中静脉或其交通支静脉吻合建立动静脉内瘘31例,其中男性20例,女性11例.全部病例及时通畅率100%,无感染以及窃血综合征等并发症发生,术后内瘘长期使用通畅率93.5%.结论 改良肘部高位动静脉内瘘手术具有手术成功率高、术后通畅率高、并发症少的特点,对于不能建立腕部内瘘通路或腕部内瘘通路失功能患者,是建立内瘘手术又一理想选择.

Objective To discuss the surgical technique and clinical application effect of modified elbow high internal arteriovenous fistula. Methods Retrospective analysis was made in the clinical application effect of the modified elbow high internal arteriovenous fistula on 31 cases in our hospital. Results Between April 2008 and June 2011 ,there were 31 cases（20 males and 11 females） in which internal arteriovenous fistulas were established by the anastomosis of proximal radial（ or ulnar）artery and the median cubital vein（ or its perforator vein）. The IEAVFs were successfully established in all patients without any complications including wound infection, turgidity at upper limbs, high output cardiac failure, steal blood syndrome and perioperative morality. The timely patency rate was 100%. Infection and steal syndrome did not occur. The long term patency rate of internal fistula after the operation was 93.5%. Conclusion The modified elbow high internal arteriovenous fistula has the advantages of high success rate, high postoperative patency rate, and less incidence of complications. This method is a new optional operation for patients with the failure or function loss of wrist arterio venous fistulas.