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目的分析洛阳市第三人民医院血液净化科近3年来长期透析患者动静脉内瘘堵塞病例的资料,分析其形成原因并观察二次手术后效果。方法对于动静脉内瘘堵塞的患者行二次动静脉内瘘取栓成形术,对动静脉内瘘形成的原因、手术方法和手术后效果等临床资料进行回顾性分析。结果近3年来长期血液透析时间>2年的患者动静脉内瘘堵塞的6例病例,临床上行二次动静脉内瘘取栓成形术后,2例失败,重新选取对侧肢体行动静脉内瘘成形术,余4例成功。观察约半年后6例患者血液透析时血流量均达到250 ml/min以上,透析效果满意。结论动静脉内瘘血栓形成后,二次手术难度大,不仅影响了患者的治疗,并且增加了患者的痛苦和经济负担,故早期预防是关键,应做好患者及其家属的宣传教育工作。
Objective To analyze the data of the occlusion of arteriovenous fistula in long-term hemodialysis patients in the Third People’s Hospital of Luoyang City during the past three years, analyze the causes and observe the effect after secondary surgery. Methods Two-dimensional arteriovenous fistula occlusion was performed in patients with arteriovenous fistula occlusion. The causes of arteriovenous fistula formation, surgical methods and postoperative outcomes were retrospectively analyzed. Results Six cases of arteriovenous fistula occluded in patients with long-term hemodialysis time> 2 years in the past three years had failed in two cases following the second arteriovenous fistula embolectomy, and the contralateral limb-motion venous fistula Plastic surgery, more than 4 cases were successful. Six months after the observation, blood flow in hemodialysis patients reached more than 250 ml / min, and dialysis was satisfactory. Conclusion After the thrombosis of arteriovenous fistula, the secondary surgery is difficult, not only affects the patient’s treatment, and increases the patient’s pain and financial burden, so early prevention is the key, and should do a good job of patients and their families of publicity and education.