改良端侧吻合结合机械及液压扩张法在动静脉内瘘术中的应用研究

The Application of Modified End-to-Side Anastomosis Combined with Mechanical and Hydraulic Distension in Arteriovenous Fistula

目的观察改良端侧吻合结合机械及液压扩张法在动静脉内瘘术中的应用。方法随机选择70例行自体动静脉内瘘术的尿毒症患者,对照组30例行常规端侧吻合内瘘术,观察组40例行改良端侧吻合结合机械及液压扩张法动静脉内瘘吻合术。比较两组患者的术后头静脉管径和头静脉血流量、手术优良率、手术成功率以及术后并发症发生率。结果观察组患者的术后吻合管径、头静脉血流量均显著优于对照组患者(P <0.05)。观察组患者的首次手术优良率为97.50%,显著高于对照组的80.00%(P <0.05),两组患者的手术成功率无显著差异(P>0.05)。观察组患者的术后并发症发生率为2.50%,显著低于对照组的20.00%(P <0.05)。结论改良端侧吻合结合机械及液压扩张法有利于改善动静脉内瘘的血流情况,减少术后并发症的发生。

Objective To observe the application of modified end-to-side anastomosis combined with mechanical and hydraulic distension in arteriovenous fistula. Methods 70 uremia patients with native arteriovenous fistula were randomly selected. 30 cases of the control group received traditional end-to-side anastomosis, and 40 cases of the observation group received modified end-to-side anastomosis combined with mechanical and hydraulic distension. The diameter and blood flow of cephalic vein after surgery, excellent and good rate of surgery, success rate of surgery, and incidence of postoperative complications were compared between two groups. Results After operation, the anastomotic diameter and cephalic vein blood flow of the observation group were significantly better than those of the control group （P 〈0.05）. The excellent and good rate of first surgery of the observation group was 97.50%, significantly higher than 80.00% of the control group （P〈0.05）; No statistical difference was found between the two groups in the success rate of surgery （P〉0.05）. The incidence of postoperative complications of the observation group was 2.50%, significantly lower than 20.00% of the control group （P 〈0.05）. Conclusions Modified end-to-side anastomosis combined with mechanical and hydraulic distension is beneficial to improve the blood flow of arteriovenous fistula and reduce the incidence of postoperative complications.