文档介绍：40例鼻烟窝部人工动静脉内瘘术的手术效果分析
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作者:王沂芹,柏健鹰,陈枫,唐建英,李慧,郭小霞,袁发焕
【摘要】目的观察40例鼻烟窝部动静脉内瘘术的效果。方法选择腕关节下鼻烟窝部桡动脉和头静脉做为自体动静脉内瘘的吻合血管,采用外科血管缝合法或钛轮钉动静脉内瘘吻合法。结果40例人工内瘘术中,钛轮钉动静脉内瘘吻合6例(15%),外科血管缝合法34例(85%),吻合成功率100%。术后第2天发生内瘘堵塞2例,内瘘成功率95%。结论鼻烟窝动静脉内瘘制作简便,保留了近端血管以备重建内瘘,能满足常规血透的血流量,可以作为维持性血液透析患者的首选的永久性血管通路。
【关键词】血液透析;人工动静脉内瘘;鼻烟窝
Abstract: Objective To investigate the effect of 40 cases with artificial arteriovenous internal fistula in nasopharyngeal fossa. Methods Forty artificial arteriovenous internal fistula in nasopharyngeal fossa were applied with titanium wheel nail or vessel suture. Results Among these 40 patients, 6 were with titanium wheel nail and 34 were with vessel suture. All the operations of 40 cases were essful. Using the arteriovenous fistula, the blood flow volume reached the requirement of hemodialysis 4 to 6 weeks after surgical procedure. Conclusion It is convenient, safe and effective to establish arteriovenous internal fistula in nasopharyngeal fossa for hemodialysis. It could be preferred vessel access for maintenance hemodialysis patients.
Keywords: hemodialysis; artificial arteriovenous internal fistula; nasopharyngeal fossa
人工动静脉内瘘是慢性肾功能衰竭维持性血透患者赖以生存的生命线。1966年Brescia等[1]首次用腕关节上方的桡动脉和它邻近的静脉直接吻合,制成经典的前臂动静脉内瘘。与经典的前臂动静脉内瘘相比[23],腕关节下方的鼻烟窝部动静脉内瘘具有美观、穿刺血管长度延长及增加建瘘部位的优点,主要应用于长期血液透析患者。我科于2008年完成了鼻烟窝处动静脉内瘘成形术40例,现将临床资料进行分析,并探讨鼻烟窝部人工