改良端侧吻合与传统端侧吻合在动静脉内瘘术中的应用比较

The application of improved end-to-side anastomosis and traditional end-to-side anastomosis in arteriovenous fistula

目的:探讨改良端侧吻合手术在动静脉内瘘术中的应用效果。方法:选择2013年-2016年80例血液透析患者作为研究对象,根据随机数字表法分为对照组(40例)和观察组(40例)。对照组采用传统端侧吻合行动静脉内瘘术,观察组采用改良端侧吻合动静脉内瘘术。比较两组吻合时间,术后1个月、3个月、6个月以及1年通畅率,术后并发症,手术优良率等指标。结果:观察组和对照组平均吻合时间分别为(22.46±5.28)min、(28.84±6.17)min,二者比较,差异具有统计学意义(P<0.05)。观察组与对照组患者手术成功率比较差异无统计学意义97.5%vs 87.5%(P>0.05)。观察组手术优良率显著高于对照组(P<0.05),两组术后3个月、6个月和1年时的通畅率比较差异无统计学意义(P>0.05)。观察组术后并发症发生率显著低于对照组2.5%vs 17.5%(P<0.05)。结论:改良端侧吻合操作简单,可缩短手术时间,提高手术成功率,减少术后并发症,方便进行手术探查和取栓操作。

Objective:To investigate the effect of improved end-to-side anastomosis on arteriovenous fistula.Methods:80 cases of hemodialysis patients from 2013 to 2016 were selected as the research subjects and divided into the control group(40 cases)and the observation group(40 cases)according to the random digital table method.The traditional end-to-side anastomosis was used in the control group,and the improved end-to-side anastomosis was used in the observation group.The anastomosis time,1 month,3 months,6 months and 1 year after the operation,postoperative complications,surgical excellent rate and other indicators in two groups were compared.Results:The average time of anastomosis in the observation group and the control group was(22.46±5.28)min and(28.84±6.17)min respectively,and the difference between two groups was statistically significant(P<0.05).There was no significant difference in the success rate between the observation group and the control group(97.5%vs 87.5%,P>0.05).The excellent and good rate of operation in the observation group were significantly higher than the control group(P<0.05).There was no significant difference in patency between two groups at 3 months,6 months and 1 year after operation(P>0.05).The incidence of postoperative complications in the observation group was significantly lower than that in the control group(2.5%vs 17.5%,P<0.05).Conclusion:Improved end-to-side anastomosis was a simple operation,which could shorten the operation time,improve operation success rate,reduce postoperative complications,and facilitate operation exploration and thrombectomy.