前臂桡-头动静脉内瘘术对高龄透析的作用分析

Analysis on the Effect of Internal Arteriovenous Fistula of Forearm Radial Head on Dialysis in Senile Patients

目的分析前臂桡-头动静脉内瘘术对高龄透析患者瘘管成熟时间及心功能的作用。方法经医院伦理学会批准随机选取医院2015年1月—2018年12月收治的慢性肾衰竭患者120例,随机数字法将其分成对照组与治疗组,每组60例。对照组患者接受标准动静脉内瘘术造瘘,治疗组患者接受前臂桡-头动静脉内瘘术造瘘。比较两组患者一般指标、动静脉内径、心功能及、不良事件及瘘管通畅情况。结果治疗组患者手术时间、内瘘成熟时间少于对照组(P<0.05),内瘘使用时间多于对照组(P<0.05)。治疗组患者头静脉内径、桡动脉内径大于对照组(P<0.05),贵要静脉内径、尺动脉内径小于对照组(P<0.05)。治疗前两组患者心功能EF值的差异无统计学意义(P>0.05),治疗后减少;其中治疗组患者EF值低于对照组(P<0.05)。治疗组患者不良事件率低于对照组(P<0.05),治疗组患者瘘管通畅率高于对照组(P<0.05)。结论前臂桡-头动静脉内瘘术能明显增加高龄透析患者瘘管使用时间,减少动静脉损伤及不良事件,保证瘘管通畅。

Objective To analyze the effect of internal arteriovenous fistula with radial head of forearm on fistula maturation time and heart function in elderly dialysis patients.Methods 120 cases of chronic renal failure patients admitted to our hospital from January 2015 to December 2018 were randomly selected with the approval of the hospital ethics society.They were divided into control group and treatment group by random number method,with 60 cases in each group.Patients in the control group received standard arteriovenous internal fistula,while patients in the treatment group received radial head arteriovenous internal fistula of forearm.General indicators,arteriovenous diameter,cardiac function,adverse events and fistula patency were compared between the two groups.Results The operation time and the maturation time of internal fistula in the treatment group were less than that in the control group(P<0.05),and the application time of internal fistula was longer than that in the control group(P<0.05).The inner diameter of the cephalic vein and radial artery in the treatment group was larger than that in the control group(P<0.05),while the inner diameter of the cardinal vein and ulnar artery was smaller than that in the control group(P<0.05).There was no significant difference in the EF value of cardiac function between the two groups before treatment(P>0.05),which decreased after treatment.The EF value of the treatment group was lower than that of the control group(P<0.05).The adverse event rate in the treatment group was lower than that in the control group(P<0.05),and the fistula patency rate in the treatment group was higher than that in the control group(P<0.05).Conclusion Internal arteriovenous fistula of forearm radial head can significantly increase the use time of fistula in elderly dialysis patients,reduce arteriovenous injury and adverse events,and ensure fistula patency.