动静脉造瘘在鼻烟壶及腕部的临床研究

来源 :华西医学 | 被引量 : 0次 | 上传用户:yatang
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目的评价在鼻烟壶及腕部行动静脉造瘘术的疗效。方法将2007年6月2009年6月收治的156例肾功能衰竭患者随机分成两组,分别在鼻烟壶及腕部行动静脉造瘘术,术后经彩色超声随访其吻合口通畅情况,临床观察瘘管使用时间及其并发症。结果术后随访2年,鼻烟壶处行动静脉造瘘术的患者,瘘管术后1年初级通畅率及累积次级通畅率分别为76.9%、92.1%;术后2年初级通畅率及累积次级通畅率分别为57.9%、78.9%。而腕部组瘘管1年初级通畅率及累积次级通畅率分别为64.1%、81.3%;术后2年初级通畅率及累积次级通畅率分别为56.0%、76.0%。两组在术后1年初级通畅率及累积次级通畅率差异有统计学意义(P<0.01),术后2年初级通畅率及累积次级通畅率差异无统计学意义(P>0.05)。结论鼻烟壶处行动静脉造瘘术的瘘管在短期内通畅率较腕部高,长期并无显著性差异。 Objective To evaluate the efficacy of venous ostomy in snuff bottles and wrists. Methods A total of 156 patients with renal failure who were admitted to our hospital in June 2007 and June 2009 were randomly divided into two groups. The patients received intravenous arterial ostomy in the snuff bottle and the wrist respectively. The follow-up results of the anastomotic patency were observed after operation. The clinical observation Fistula usage time and its complications. Results After 2 years of follow-up, the primary patency rate and cumulative secondary patency rate of fistula patients at 1 year after operation were 76.9% and 92.1% respectively. The primary patency rate and cumulative times of 2 years after operation Patency rates were 57.9%, 78.9%. The 1-year primary patency rate and cumulative secondary patency of the wrist group were 64.1% and 81.3%, respectively. The primary patency rate and secondary patency rate after 2-year surgery were 56.0% and 76.0%, respectively. There was a significant difference in primary patency rate and cumulative secondary patency rate between the two groups at 1 year after operation (P <0.01). There was no significant difference in primary patency rate and cumulative secondary patency rate at 2 years after operation (P> 0.05) . Conclusions Fistulas at the arteriovenous fistula at the snuff bottle have higher short-term patency rates than those at the wrists, with no significant difference in the long term.
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