两种前臂环形人工血管动静脉内瘘术式的比较

Comparison of cross-joint and regular forearm loop arteriovenous graft for hemodialysis

目的:比较分析前臂环形跨关节与不跨关节两种人工血管动静脉内瘘的临床特点。方法:回顾性分析2015年1月至2018年1月于重庆医科大学附属第一医院行前臂环形人工血管动静脉内瘘患者的资料,比较两种构建方式在通畅率、并发症等方面的差别。结果:纳入85例患者,跨关节人工血管内瘘56例;不跨关节29例。跨关节组术前透析龄明显更长(46.04±37.79月vs 2.99±3.91月,P<0.05),1年一期通畅率(47.62%vs 58.62%)、二期通畅率(98.18%vs 100%)与不跨关节组无统计学差异,但年均腔内介入干预次数更多(0.71次vs 0.45次,P<0.05)。结论:肘部没有其他静脉可选患者,前臂环形跨关节人工血管动静脉内瘘也是一种可行的内瘘构建方式。

Objective:To compare cross-joint forearm loop arteriovenous graft(fAVG)with regular fAVG.Methodology:The patients who created these two type of fAVGs during Jan 2015 and Jan 2018 were retrospective analyzed,complications and patency rate between two groups were compared.Results:A total of 85 patients were enrolled in our study(56 cross-joint fAVGs and 29 regular fAVGs).The cross-joint group had a longer dialysis vintage(46.0±37.8 months vs 2.99±3.91 months,P<0.05),while the one year primary patency(47.6%vs 58.6%)and secondary patency(98.18%vs 100%)were similar to the regular group.However,the cross-joint group received more interventions per year to maintain the secondary patency(0.71 time vs 0.45 time).Conclusion:The cross-joint fAVG was a feasible alternative for patients without other venous options at the elbow.