原位二次动静脉内瘘吻合术后不同时间穿刺的效果比较

Compare of puncture effect after different time of situ secondary arteriovenous fistula anastomosis surgery

目的:探讨原位二次动静脉内瘘(AVF)吻合术后不同时间穿刺的临床效果。方法:选择我科收治的发生AVF失功能后行原位二次AVF吻合术的血液透析患者50例,随机等分为对照组和观察组,对照组术后即行深静脉临时置管维持正常透析,1个月后再进行内瘘穿刺,观察组术后首次透析即行内瘘穿刺,比较两组患者术后第1,3,6,12个月时的AVF血流量及术后12个月穿刺相关并发症的发生率。结果:两组患者在术后第1,3,6,12个月时的AVF血流量均达到230 ml/min以上,两组出现穿刺相关并发症的总发生率比较差异具有统计学意义(P<0.05)。结论:原位二次AVF吻合术后首次透析即进行内瘘穿刺不仅能保证充足的血流量,如若采用恰当的穿刺方法,还可能会减少术后假性动脉瘤和内瘘狭窄等相关并发症。

Objective：Compared of clinical effects about puncture at different times after situ secondary arteriovenous fistula（ AVF）anastomosis surgery. Methods：Choose 50 hemodialysis patients by department treated in recent years who made situ secondary AVF anastomosis surgery after AVF Loss of func-tion. Randomly divided into control group（made deep venous catheter line temporarily to maintain normal dialysis after surgery,then made fistula puncture after a month）and observation group（made fistula puncture performed immediately at first hemodialysis after surgery）. Compared of AVF blood flow of two groups patients at 1,3,6,12 month after surgery,and the incidence of biopsy - related complications at 12 monthes after surgery. Results：The AVF blood flow of two groups patients could reach more than 230 ml/ min at 1,3,6,12 month after surgery. The complications of control group was higher than the ob-servation group（P 〈 0. 05）. Conclusion：Made fistula puncture performed immediately at first hemodialysis after situ secondary AVF anastomosis surgery not only ensured adequate blood flow,but slao might reduce postoperative complications if puncture using appropriate methods.