人工血管桥接处理血透通路回流静脉狭窄/闭塞的效果分析

Analysis of the effect of prosthesis bridging in the treatment of vascular access outflow stenosis/occlusion

目的探讨人工血管桥接处理血透通路回流静脉狭窄/闭塞病变的效果。方法回顾性分析重庆医科大学附属第一医院2020年1月至2023年1月61例通过人工血管桥接处理回流静脉狭窄/闭塞患者的血透通路基本信息及手术信息、随访术后情况。结果患者住院时间为4~11d,平均(6.27±1.01)d。术后随访6~38个月,平均(19.36±10.30)个月,随访期有4例患者发生与血管通路无关的死亡,进行54例次再干预,11例患者不再使用原通路透析。术后6、12、24、36个月初级通畅率分别为73.8%、58.1%、46.1%、15.4%,次级通畅率分别为91.8%、89.7%、84.8%、56.5%。结论使用人工血管桥接处理血透通路回流静脉病变具有满意的效果,但仍需选择更合适的直径、长度、材质的人工血管来提升术后通畅率。

Objective To explore the effect of prosthesis bridging in the treatment of vascular access outflow stenosis/occlusion.Methods The clinical data of 61 patients with outflow stenosis/occlusion and receiving prosthesis bridging in the First Affiliated Hospital of Chongqing Medical University from January 2020 to January 2023 were collected retrospectively.Basic information of hemodialysis access,surgical information and postoperative conditions of followed up were analyzed.Results The hospital stay of the patients was 4 to 11 days,with an average of(6.27±1.01)days.Postoperative follow-up was 6 to 38 months,with an average of(19.36±10.30)months.During the follow-up period,4 patients died unrelated to vascular access,54 cases of re-intervention were performed,and 11 patients no longer used the dialysis access receiving bridging.The primary patency rates at 6,12,24 and 36 months were 73.8%,58.1%,46.1%,15.4%,respectively,and the corresponding secondary patency rates were 91.8%,89.7%,84.8%,56.5%,respectively.Conclusion The use of prosthesis bridging to treat vascular access outflow stenosis/occlusion has satisfactory results.However,it is still necessary to select more suitable diameter,length and material of prosthesis to improve the postoperative patency rate.