人造血管内瘘进行高通量血液透析的临床应用

目的 报道采用人造血管移植动—静脉内瘘术进行高通量血液透析的临床应用效果。方法 尿毒症患24例，行聚四氟乙烯(FrrFE)人造血管移植动—静脉内瘘术，进行高通量血液透析(HFD)，透析器采用Fresenius F60。观察血流量和并发症发生率。结果人造血管通畅率100％，HFD时血流量均可达到300～450ml／min。术后感染发生率4．17％，血栓形成发生率8．33％，假性动脉瘤发生率4．17％；HFD低血压发生率37．5％，反超滤发生率12．5％。结论 人造血管具有生物相容性好、通畅率高、使用时间长和易穿刺等优点，是血液透析患移植内瘘的理想选择；人造血管动—静脉内瘘能为HFD提供足够的血流。

Clinical application of artificial fistula in high-flux hemodialysis

Objectives To investigate the clinical application of artificial fistula in high-flux hemodialysis. Methods Twenty-four uremia patients received PTFE artificial blood vessel grafting for arteriovenous fistulization,these patients received high-flux hemodialysis with Fresenius F60 dialyser.Volume of blood flo w and incidence of complication were observed. Results All of arteriovenous fistul were successfully formed. The volume of blood flow varied from 3 00ml/min to 450ml/min.The incidence rate of infection was 4.17% after operation. The incidence of thrombosis was 8.33%.The incidence of false aneurysm was 4.17% ;In the course of HFD,the incidence of hypotension was 37.5%.The incidence of ba ckfiltration was 12.5%. Conclusion ePTFE is a good alternative for constructing dialys is access in patients with difficulty to establish direct arteriovenous fistulia in HFD.The artificial fistulia could provide sufficient volume of blood flow.