人造血管内瘘进行高通量血液透析的临床应用

Clinical application of artificial fistula in high-flux hemodialysis

目的 报道采用人造血管移植动 -静脉内瘘术进行高通量血液透析的临床应用效果。方法 尿毒症患者 2 4例 ,行聚四氟乙烯 (PTFE)人造血管移植动 -静脉内瘘术 ,进行高通量血液透析(HFD) ,透析器采用FreseniusF60。观察血流量和并发症发生率。结果 人造血管通畅率 10 0 % ,HFD时血流量均可达到 3 0 0～ 450ml/min。术后感染发生率 4.17% ,血栓形成发生率 8.3 3 % ,假性动脉瘤发生率 4.17% ;HFD低血压发生率 3 7.5% ,反超滤发生率 12 .5%。结论 人造血管具有生物相容性好、通畅率高、使用时间长和易穿刺等优点 ,是血液透析患者移植内瘘的理想选择 ;人造血管动 -静脉内瘘能为HFD提供足够的血流。

Objectives To investigate the clinical application of artificial fistula in high-flux hemodialysis. Methods Twenty-four uremia patients received PTFE artificial blood vessel grafting for arteriovenous fistulization,these patients received high-flux hemodialysis with Fresenius F60 dialyser.Volume of blood flo w and incidence of complication were observed. Results All of arteriovenous fistul were successfully formed. The volume of blood flow varied from 3 00ml/min to 450ml/min.The incidence rate of infection was 4.17% after operation. The incidence of thrombosis was 8.33%.The incidence of false aneurysm was 4.17% ;In the course of HFD,the incidence of hypotension was 37.5%.The incidence of ba ckfiltration was 12.5%. Conclusion ePTFE is a good alternative for constructing dialys is access in patients with difficulty to establish direct arteriovenous fistulia in HFD.The artificial fistulia could provide sufficient volume of blood flow.