梯形对称二等分叶小血管吻合法在动静脉内瘘术中的应用

Application of small vascular anastomosis with two trapezoid and symm etrical lobulated flap to creating arteriovenous fistulas

目的 探讨应用梯形对称二等分叶小血管吻合法施行头静脉桡动脉内瘘手术的临床效果。方法 门诊采用梯形对称二等分叶法吻合头静脉桡动脉形成内瘘 44例。结果 术后 44例中 42例内瘘通畅良好 ,1例因术后血管危象而失败行二次手术后内瘘通畅 ,1例因血流量不足放弃使用 ,42例使用良好。动静脉内瘘使用 3～ 2 8个月 ,最多已穿刺达 2 0 0余次 ,内瘘使用仍良好。结论 采用梯形对称二等分叶法吻合头静脉桡动脉建立内瘘术 ,操作简便 ,吻合速度快 ,成功率高 ,效果满意 ,并发症少 。

Objective To investigate the clinical effect of r ad iocephalic arteriovenous internal fistulas created by anastomosis with two trape zoid and symmetrical lobulated flap. Methods Fourty-four cases were performed operation of anastomos is with two trapezoid and symmetrical lobulated flap in outpatient department.Results The internal arteriovenous fistulas of 42 cases were un obstructed,one fistula obstructed because of vessel crisis,but the second operat ion was successful.Another fistula was discard because of low blood flow.In 42 c ases,the internal arteriovenous fistulas were used well from 3 months to 28 mont hs after operation,and one fistula was punctured 200 times,and it is still unobs tructed.Conclusion Anastomosis with two trapezoid and symmetrical lobul ated flap for creating internal arteriovenous fistulas is an optional method for maintenance hemodialysis. It decreased the operative time,and improved success rate of internal arteriovenous fistulas.