中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (03): 335-338.DOI: 10.19538/j.cjps.issn1005-2208.2023.03.17

• 论著 • 上一篇    下一篇

即穿型人工血管在血液透析通路中的应用与长期疗效分析

  

  1. 上海交通大学医学院附属仁济医院血管外科，上海200127
  • 出版日期:2023-03-01 发布日期:2023-03-22

倪其泓，赵意平，王韦仑，杨硕菲，张    岚，陈佳佺   

  • Online:2023-03-01 Published:2023-03-22

摘要： 目的    分析单中心即穿型人工血管应用于血液透析通路的36个月长期疗效。方法    回顾性分析上海交通大学医学院附属仁济医院自2018年1月至2019年12月收治的采用即穿型人工血管建立的移植物动静脉内瘘（AVG）病人的临床资料，搜集病人的基线资料、术中情况、术后穿刺时间、术后并发症及通畅率情况，根据病人的超声随访，分为规律随访组与未规律随访组，比较两组的通畅率。结果    总共有75例病人纳入研究，其中男性39例，女性36例，平均年龄为（60.1±15.8）岁，平均术后首次穿刺时间为（3.3±2.2） d。平均随访时间为（39.2±8.5）个月，术后12个月、24个月、36个月的一期通畅率分别为62.7%、40.0%、21.3%，一期辅助通畅率分别为77.3%、50.7%、33.3%，二期通畅率分别为94.7%、90.7%、89.3%。规律随访组的一期辅助通畅率显著高于未规律随访组（P值分别为0.026、0.027和0.008）。结论    即穿型AVG的长期通畅率结果满意，规律超声随访可以有效提高术后一期辅助通畅率，减少急性血栓形成。

关键词: 即穿型, 人工血管, 血液透析通路, 通畅率

Abstract: Application and long-term efficacy analysis of early cannulation graft in hemodialysis access        NI Qi-hong, ZHAO Yi-ping, WANG Wei-lun, et al. Department of Vascular Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University，Shanghai 200127，China
Corresponding author：CHEN Jia-quan, E-mail:chenjiaquan@renji.com
Abstract    Objective    To analyze the 36-month long-term efficacy of early cannulation graft in hemodialysis access at a single center. Methods    From January 2018 to December 2019, Renji Hospital, School of Medicine, Shanghai Jiaotong University retrospectively analyzed the clinical data of patients with arteriovenous fistula（AVG）using early cannulation grafts in a single center. The baseline data, intraoperative conditions, postoperative puncture time, postoperative complications, and patency rate were collected. According to the ultrasonic follow-up of the patients, the patients were divided into a regular follow-up group and an irregular follow-up group, and the patency rates of the two groups were compared. Results    A total of 75 patients were included in the study, including 39 males and 36 females. The average age was（60.1±15.8）years, and the average first puncture time after the operation was（3.3±2.2）days. The mean follow-up time was（39.2±8.5）months. The primary patency rates were 62.7%, 40.0%, and 21.3% at 12, 24, and 36 months, respectively. The primary assisted patency rates were 77.3%, 50.7% and, 33.3%, respectively. The secondary patency rates were 94.7%, 90.7%, and 89.3%, respectively. The primarily assisted patency rate in the regular follow-up group was significantly higher than that in the irregular follow-up group. Conclusion    The results of the long-term patency rate of early cannulation graft AVG are satisfactory. Regular ultrasound follow-up can effectively improve the primary assisted patency rate and reduce AVG thrombosis.

Key words: early cannulation, arteriovenous graft, hemodialysis access, patency rate