自体动静脉内瘘发生初期手术失败的原因分析

What cause the early failure of Autogenous arteriovenous fistula

目的探讨导致自体动静脉内瘘发生初期手术失败的相关原因。方法我院2013-2014年为180例患者行自体动静脉内瘘手术,将其中21例发生初期手术失败的患者定为失败组,余159例定为对照组。比较两组患者的术前血压和血管内径。同时,为失败组患者重新进行物理学检查、复查上臂彩超或血管造影,并请经验丰富的高年资手术医师再次手术,寻找初期手术失败的原因。结果收缩压、舒张压水平及动、静脉血管内径在两组间差异有统计学意义,失败组较对照组低。此外,医者的术前检查、手术血管的选择和手术技巧与初期手术的失败有直接相关性。结论血管条件、术前检查、手术血管和部位的选择和手术技巧是初期手术成败的影响因素。

Objective To explore the reasons of the early failure of autogenous arteriovenous fistula surgery. Methods-From 2013 to 2014 in our hospital,patients with autogenous arteriovenous fistula surgery attained to 180 cases,21 cases of them occurred early surgery failure patients as a group named failure group,the other 159 cases as control group. Comparison of two groups of patients with preoperative blood pressure and blood vessel diameter. At the same time,the failure group of patients return visit the ultrasound or angiography,and experienced high qualification surgery doctors surgery again,to find the causes of failure of early surgery. Results Systolic pressure,diastolic blood pressure level,arteries and veins inside diameter difference between the two groups was statistically significant,failure group was lower than those of control group. In addition,the doctor of the preoperative examination,blood vessels of the choice,surgical technique,has a direct connection between early surgery failure. Conclusions Vascular conditions,preoperative examination,blood vessels and the location choice,and the operation skills are the influence factors of early surgery success or failure.