摘要
目的 了解影响动静脉内瘘成功的因素。方法 40例新建内瘘病例术中测动静脉管径、动脉血流量、吻合口口径、内瘘血流量及术前平均动脉压。其中 ,18例还进行多普勒超声检查 ,测量术前动静脉管径、动脉血流量及术后连续 6周随访内瘘血流量和管径。结果 通过单因素、多因素回归分析 ,平均动脉压、动脉血流量与术后短时间的内瘘血流量呈正相关 (P <0 0 5 ) ;静脉管径与术后内瘘血流量呈正相关 (P <0 0 5 )。术后随访期内瘘血流量和管径随时间逐渐增加 (P <0 0 5 )。结论 低血压、静脉管径细会造成内瘘失败 ,术前动脉血流量达到 2 0ml/min术后可很快获得满意的血流量 ;吻合口口径在 8～ 10mm较为适宜 ;内瘘的使用尽量在 6周以后。
Objective To evaluate the factors associated with arteriovenous fistula. Methods Mean arterial pressure(MAP), and radial arterial inflow(AI),diameter of artery(AD) and vein(VD), anastomosis size(ANS) and fistula flow(FF) during operation in 40 newly constructed fistula were measured.In 18 patients, AI, AD, VD, FF were also measured preoperation and postoperation by doppler ultrasound.Results By univariate and multivariate regression analyses , MAP and AI had positive correlation with fistula flow just after operation(P<0.05), VD had positive correlation with postoperative fistula flow(P<0 05). End-side fistula flow was greater than end-end fistula flow(P<0 05). After operation fistula flow and diameter increase gradually with time(P<0 05). Conclusion Patients with hypotension and small vein will have a higher risk of fistula failure. If radial artery inflow≥20 ml/min, fistula flow will soon >200 ml/min. In end-side AV fistula the anastomosis size should be 8～10 mm. Vein end-artery side fistula can get greater flow with lower complication rate. The fistula should not be punctured until the 6th week. Doppler ultrasound is helpful to select suitable vessels preoperation and assesses fistula maturation postoperation.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
1999年第5期298-301,共4页
Chinese Journal of Nephrology
