血液透析人工血管动静脉内瘘感染的外科治疗

Chinese Journal of Practical Surgery ›› 2024, Vol. 44 ›› Issue (12) : 1378-1381.

Chinese Journal of Practical Surgery ›› 2024, Vol. 44 ›› Issue (12) : 1378-1381. DOI: 10.19538/j.cjps.issn1005-2208.2024.12.13

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Abstract

Infection is the most serious complication of arteriovenous graft (AVG). Timely diagnosis and treatment are of great significance to prevent the spread of infection. Antimicrobial de-escalation combined with negative pressure wound therapy is the basic treatment. According to the range of infection, the overall condition of the patient, and AVG itself, the range of graft explantation is determined. For patients with relatively limited infection, partial graft explantation combined with one-stage or two-stage new graft by-pass is more favorable for the long-term prognosis of hemodialysis patients, although with a higher risk of reinfection. However, more details need to be noticed during the operation to reduce the risk of reinfection. In the perioperative and later stages of AVG cannulation, standardized aseptic protocol, and careful management are important for infection prevention. At present, some new graft material provide a new idea for reducing AVG infection, which is expected to bring new hope for high-quality long-term survival of dialysis patients.

Key words

arteriovenous graft / infection / partial graft explantation

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