动静脉造瘘在鼻烟壶及腕部的临床研究

【】　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（P0.05）。　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。【Abstract】　Objective　Toevaluatetheeffectofartificialarteriovenousfistulabetweentabatiereanatomiqueandwrist.　Methods　FromJune2007toJune2009,156casesofrenalfailurewererandomlydividedintotwogroups,andunderwentartificialarteriovenousfistulaontabatiereanatomiqueorwrist,respectively.ThepatencyoftheanastomoticstomawasobservedviaBultrasonography.　Results　Thepatientswerefollowedupfortwoyearspostoperative.Aftertheoperation,theprimarypatencywas76.9%atthefirstyearand57.9%atthesecondyearintabatiereanatomiquegroup;cumulativesecondarypatencywas92.1%atthefirstyearand78.9%atthesecondintabatiereanatomiquegroup;primarypatencywas64.1%atthefirstyearand56.0%atthesecondinwristgroup;cumulativesecondarypatencywas81.3%atthefirstyearand76.0%atthesecondyearinwristgroup.Theprimarypatencyandcumulativesecondarypatencyweresignificantlydifferentbetweentabatiereanatomiquegroupandwristgroupatthefirstyearpostoperatively(P0.05).　Conclusion　Prophasepatencyoftabatiereanatomiqueishigherthanthatofwrist.Therewasnosignificantdifferencebetweentheminalongterm.