两种桡动脉头静脉血管造瘘方法的临床探索

目的 探索采用钛轮钉进行动静脉血管吻合与显微外科进行动静脉血管缝合两种手术方法进行血管造瘘的临床效果。方法 将300例准备接受维持性血液透析的尿毒症患者随机分为两组，分别由内科医师采用钛轮钉进行桡动脉头静脉血管吻合（钛轮钉组）及显微外科医师进行桡动脉头静脉血管缝合（缝合组）造血管内瘘，通过观察手术切口长度、术中出血量、手术时间、血液透析时的血流量、手术费用及内瘘1年通畅率评价手术效果。结果 钛轮钉组在切口长度，术中出血量，手术时间及手术费用方面均优于缝合组（P〈0．01）。但是在透析过程中的血流量不及缝合组（P〈0．05）。术后1年血管内瘘通畅率两组之间无显著性差异（P〉0．05）。结论 采用钛轮钉进行动静酥血管吻合造癌具有手术切口小、出血少、时间短、速度快等优点。

Clinical Exploration of two Methods of Constructing Radial Artery-cephalic Vein Fistul

Objective To investigate the clinical effects of two methods of constructing radial artery-cephalic vein(AV) fistula.Methods Three hundred uremic patients prepared for maintenance hemodialysis were divided into two groups randomly.One group received the end-end of AV anastomosis with cyclic titanium nail(the cyclic-titanium-nail group),the another group used microsurgical suture(the suture group).The operating effects were eluate by measuring the incision length,bleeding volume during operation,blood flow volume in hemodialysis,operating time and fee,and the fluency rate of fistula in one year.Results Thecyclic-titanium-nail group was superior to the suture group in incision length,bleeding volume during operation,operating time and fee(P<0.01),but less blood flow volume in hemodialysis(P<0.05).There was no significant diffrence fluency rate of fistula in one year between two groups(P>0.05).Conclusion Constructing AV fistula with cyclic titanium nail has the advantage of small incision,less bleeding volume,short time and quick speed.