血液透析人工血管动静脉内瘘术及术后闭塞的治疗
Effectiveness of Polytetrafluoroethylene Graft for Hemodialysis Access and Treatment of Graft Occlusion
查看参考文献6篇
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文摘
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目的评估聚四氟乙烯人工血管建立透析通路的通畅率,总结人工血管动静脉内瘘闭塞的治疗经验。方法回顾性分析2003年3月至2008年12月在北京协和医院血管外科行上臂人工血管襻式造瘘术的30例血液透析患者的临床资料。结果平均随访时间(28.7±17.6)个月(878个月)。围手术期死亡率为0。1年初级通畅率为70.0%,累积次级通畅率为90.0%;2年初级通畅率为56.7%,累积次级通畅率为80.0%。术后并发症包括人工血管初期闭塞13例(43.3%),静脉端吻合口狭窄1例(3.3%),人工血管感染2例(6.7%),肢体肿胀10例(33.3%)。共行修复手术24例次,包括单纯取栓术12例次,取栓加人工血管补片静脉端吻合口成型4例次,同时行动静脉端吻合口成型2例次,吻合口球囊扩张2例次,取栓失败后再次于对侧肢体行人工血管动静脉内瘘1例次,人工血管取出3例次。结论人工血管动静脉内瘘是自身血管条件差的尿毒症期患者重要的透析备选途经,针对不同病因治疗人工血管闭塞可延长人工血管的使用寿命。 |
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其他语种文摘
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Objective To assess the patency and complications of the polytetrafluoroethylene(PTFE) graft for hemodialysis access and to summarize the experiences in the treatment of graft occlusions. Methods The clinical data of 30 patients who underwent forearm PTFE graft for hemodialysis access from March 2003 to December 2008 in our hospital were retrospectively analyzed. Results Patients were followed up for(28.7±17.6) months(range: 8-78 months).The peri-operative mortality was zero. Primary patency rate was 70.0% at Year 1 and 56.7% at Year 2.Accumulative secondary patency rate was 90.0% and 80.0%, respectively at Year 1 and Year 2.Postoperative complications included graft thrombosis(n=13,43.3%), venous anastomosis stenosis(n=1,3.3%), graft infection(n=2,6.7%), and edema of the forearm(n=10,33.3%).Totally 24 graft revisions were performed, including thrombectomy(12 times), thrombectomy and venous anastomosis plasty with artificial patch(4 times), arterial and venous anastomosis plasty with patch(2 times), venous anastomosis angioplasty with a balloon(2 times), new graft hemodialysis access construction in the contralateral arm(1 case), and graft removal(3 cases).Conclusions PTFE graft is an important backup hemodialysis access in urinemic patients. Proper revision according to different cause of graft occlusions can prolong the service time of the graft. |
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来源
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中国医学科学院学报
,2010,32(3):324-327 【核心库】
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DOI
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10.3881/j.issn.1000-503x.2010.03.018
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关键词
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人工血管
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血液透析
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动静脉内瘘
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地址
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1.
中国医学科学院北京协和医学院北京协和医院血管外科, 北京, 100032
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山东省青州市人民医院普外科, 山东, 青州, 262500
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语种
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中文 |
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文献类型
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研究性论文 |
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ISSN
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1000-503X |
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学科
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外科学 |
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文献收藏号
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CSCD:3902896
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参考文献 共
6
共1页
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2.
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