改良式动静脉内瘘成形术在ESRD细小静脉患者中的应用

Application of modified arteriovenous fistuloplasty in patients with small veins in ESRD

目的探讨改良式动静脉内瘘(AVF)成形术在终末期肾病细小静脉患者中的应用价值。方法选取2018年6月~2019年6月茂名市中医院血液净化中心收治的ESRD患者48例为观察对象,其中选取细小静脉(静脉直径范围1.50~2.40mm)患者24例作为研究组,同时选取头静脉在2.50mm以上的患者24例为对照组。研究组采用改良式动静脉内瘘成形术,对照组采用传统前臂自体内瘘方式,比较两组的首次内瘘使用时间、血透流量、并发症以及头静脉血流量。结果在首次内瘘使用时间、血透流量及头静脉血流量三个指标上,研究组与对照组比较差异无统计学意义(P>0.05)。在并发症发生率方面,研究组和对照组分别为8.33%、12.50%,研究组略低于对照组,但差异无统计学意义(P>0.05)。结论细小静脉患者行改良的造瘘手术也拥有较大的成功机会且效果较好,值得临床推广。

Objective To investigate the application value of modified arteriovenous fistuloplasty(AVF)in patients with small veins in end-stage renal disease(ESRD).Methods 48 ESRD patients admitted and treated at the blood purification center of Maoming Traditional Chinese Medicine Hospital from June 2018 to June 2019 were selected in this experiment as the observation objects,wherein 24 patients with small veins(1.50mm to 2.40mm in venous diameter)were selected as observation objects in the study group,while 24 patients with cephalic veins over 2.50mm were selected as observation objects in the control group.Modified arteriovenous fistuloplasty was adopted in the study group,while traditional forearm autogenous fistula was adopted in the control group.The first application time of fistula,hemodialysis flow,complications,and blood flow volume in cephalic vein were compared between the two groups.Results There was no statistically significant difference in first application time of fistula,hemodialysis flow,and blood flow volume in cephalic vein between the study group and the control group(P>0.05).In terms of the incidence of complications,the study group and control group were 8.33%and 12.50%,respectively.The study group was slightly lower than the control group,but without statistically significant difference(P>0.05).Conclusion Modified fistulation in patients with small veins also has a greater chance of success and a better effect,which is worthy of clinical promotion.