一体化血管通路团队管理对人工血管移植动静脉内瘘的作用

目的：探讨一体化血管通路团队管理人工血管移植动静脉内瘘（AVG）的效果。方法：以2017年1月至2018年12月期间温州医科大学附属第二医院收治的106例行连续AVG成功的血液透析患者为研究对象。应用随机数字表法将其分为对照组54例和研究组52例。对照组给予常规的血管通路管理，研究组纳入血管通路团队的管理。对参与者进行前瞻性随访，观察内瘘成熟和通路通畅情况。AVG通畅率估算应用Kaplan-Meier法，生存曲线之间的比较采用Log-Rank检验。结果：对照组初级内瘘成熟率为77.8%（42/54），研究组初级内瘘成熟率为92.3%（48/52），差异有统计学意义（χ2=4.364，P=0.037）。对照组1年累积初级通畅率为52.7%，研究组1年累积初级通畅率为63.9%，2组之间的初级通畅生存曲线存在显著差异（χ2=4.071，P=0.044）。结论：实施一体化血管通路团队管理能够提升AVG内瘘成熟率和通畅率，具有一定的临床实践意义。

Effect of integrated vascular pathway team management on intravenous fistula of artificial vascular transplantation

Objective: To explore the effect of integrated management of vascular access team on artificial arteriovenous graft. Methods: From January 2017 to December 2018, 106 eligible hemodialysis patients who underwent continuous successful AVG were admitted to the Second Affiliated Hospital of Wenzhou Medical University. The participants were randomly divided into the control group and the study group by using a random number table. The control group was given routine vascular access management, and the study group was included in the management of the vascular access team. The participants were followed up prospectively to observe the fistula maturity rate and the primary patency rate. Kaplan-Meier method was used to estimate the AVG patency rate, and Log-Rank tests were used to compare survival curves. Results: The primary maturation rates of AVG were 77.8% (42/54) and 92.3% (48/52) in the control group and in the study group, respectively. There was a significant difference between the two groups (χ2=4.364, P=0.037). The one-year cumulative primary patency rates were 52.7% and 63.9% in the control group and in the study group, respectively. There was a significant differences in primary patency survival curves between the two groups (χ2=4.071, P=0.044). Conclusion: Establishing a vascular access team can improve the maturation rate and the patency rate of AVG.