从“金疮”论治血液透析患者自体动静脉内瘘穿刺并发症

Discussion on the Treatment of Complications of Autologous Arteriovenous Fistula Puncture in Hemodialysis Patients from the Perspective of“Metal-Inflicted Wound”

慢性肾衰竭终末期患者普遍接受维持性血液透析(MHD)治疗,自体动静脉内瘘(AVF)是MHD患者首选的血管通路,经多次内瘘穿刺后,AVF穿刺伤将导致血肿、血管狭窄、周围组织纤维化、感染、血管瘤等一系列并发症。目前临床上尚缺乏有效的防治措施,中医药治疗AVF穿刺并发症具有较好疗效,结合AVF穿刺并发症的病理机制,以及临床治疗经验,从“金疮”论治AVF穿刺并发症,为临床治疗提供新的理论依据与指导策略。

Patients with end-stage chronic renal failure generally receive maintenance hemodialysis(MHD)treatment.Autogenous arteriovenous fistula(AVF)is the preferred vascular access for MHD patients.After multiple punctures of the AVF,the puncture wound will cause a series of complications such as hematoma,vascular stenosis,peripheral tissue fibrosis,infection,and hemangioma.Currently,there is a lack of effective prevention and treatment measures in clinical practice.However,traditional Chinese medicine has shown good efficacy in treating AVF puncture complications.Combining the pathological mechanisms of AVF puncture complications with clinical treatment experience,treating AVF puncture complications from the perspective of“Metal-inflicted Wound”provides new theoretical basis and guidance strategies for clinical treatment.