鼻烟窝自体动静脉内瘘在糖尿病肾病中的临床应用

Clinical Study of Snuffbox Arteriovenous Fistula in Diabetic Nephropathy Patients

【目的】探讨糖尿病肾病患者在维持性血液透析（MHD）治疗中建立鼻烟窝自体动静脉内瘘的临床特点和可行性。【方法】回顾性分析本院50例行鼻烟窝动静脉造瘘术患者，根据患者是否患有糖尿病肾病分为两组，糖尿病肾病组，18例；非糖尿病肾病组，32例，比较两组患者不同时间内瘘功能评级和内瘘成熟时间以及两组患者的并发症发生情况。【结果】两组患者的内瘘功能评级在术后d1、第一次血液透析时相比较差异无显著性（P〉0．05），而手术当日、规律血液透析后相比较差异有显著性（P〈0．05）。两组患者并发症发生率相比较差异无显著性。【结论】糖尿病肾病患者建立鼻烟窝自体动静脉内瘘用于维持性血液透析安全有效。

[Objective]To investigate the effects of snuffbox arteriovenous fistula （SAVF） operation in hemodial- ysis patients with diabetic nephropathy （DN）. [Methods]The clinical effects of 50 cases of SAVF patients between the DN group with 18 patients and the non-DN group with 32 patients were compared. The function of SAVF ,fistula maturation time, and complications on the postoperative day, on the first day after the operation, on the first hemodi- alysis day, and on regular hemodialysis day of two groups were observed. [Results]There were no statistically signifi- cant differences between the two groups on the first day after the operation or the first hemodialysis day （ P 〉0.05）, but the differences between the two groups had statistical significance on the postoperative day and on regular hemodi- alysis day（ P 〈0.05）. There was no significant difference in the occurrence of complications. [Conclusion]SAV-F is one of the best choices for hemodialysis patients with diabetic nephropathy.