上肢与下肢人工血管动静脉内瘘通畅率及并发症的比较

Comparison of the patency rates and complications of arteriovenous graft in lower versus upper extremities

目的探讨上肢与下肢人工血管动静脉内瘘(AVG)的通畅率及并发症发生情况。方法选取2016年1月至2018年2月于重庆医科大学附属第一医院金山医院127例建立AVG患者临床资料,其中上肢AVG110例,下肢AVG17例。统计分析患者的临床特征、术后初级通畅率、次级通畅率、并发症等。结果上肢AVG组患者女性比例低于下肢AVG组,术前透析时间短于下肢AVG组,差异均有统计学意义(P<0.05)。两组患者感染、狭窄、血栓形成并发症发生率比较,差异均无统计学意义(P>0.05)。两组患者术后6、12、18、24个月的初级通畅率及次级通畅率比较,差异均无统计学意义(P>0.05)。结论上肢AVG与下肢AVG具有相似的通畅率及并发症发生率,当上肢血管资源耗竭时,下肢AVG是可靠的替代补充透析通路形式。

Objective To compare patency rates and complications of arteriovenous graft(AVG)in the lower and upper extremities.Method Information of 127 patients with AVG in Jinshan Hospital,the First Affiliated Hospital of Chongqing Medical University from January 2016 to February 2018 were selected,including 110 grafts in upper limb and 17 grafts in lower limb.The clinical characteristics,primary patency rate,secondary patency rate and complications were analyzed statistically.Result There were less females and shorter dialysis time in the upper extremity AVG group(P<0.05).There were no significant differences in the incidence of complications including infection,stenosis and thrombosis(P>0.05).There were no significant differences in the primary patency rates and secondary patency rates at 6,12,18,24 months after surgery(P>0.05).Conclusion There are similar patency rates and complications between the upper extremity grafts and the lower extremity grafts.Lower limb AVG is a viable option among hemodialysis patients who have exhausted all options for a permanent vascular access in both upper extremities.