血液透析患者动静脉内瘘动脉瘤形成原因分析

目的 研究血液透析患者动静脉内瘘动脉瘤形成的原因及预防措施。方法 选取我科透析患者60例，其中鼻咽窝7例。左右前臂内瘘53例（第二次同侧手臂手术14例）；穿刺方法为绳梯式穿刺和局域穿刺；止血方法主要采用弹力绷带压迫法。结果 60例中有动脉瘸10例，假性动脉瘸1例，使用瘘口手术术式，在鼻咽窝、左右前臂一次瘘、第二次瘘在同侧手臂处出现动脉瘸分别为1,2、2例。结论 内瘘动脉瘸形成与血管局部方法穿刺、止血方式及动脉硬化基础等因素有关，采取预防措施可保护内瘘。

CAUSATION OF ARTERIO- VENOUS FISTULA ANEURYSM FORMATION IN HEMODIALYSIS PATIENTS

Objective To investigate the cause of native arterio- venous fistula aneurysm and prevention measures. Methods There were 7 cases with snuff- box arteriovenous fistula and 53 cases with brachiocephalic fistulas. Among them, 14 patients had to made second fistulas in the same arm. Spring tape around the arm was used to stop bleeding after dialysis. Results There were 10 cases with aneurysm and 1 cases with pseudo- aneurysm in 60 patients. 1, 2,2 cases with aneurysm were found in snuff- box,second fistulas in the same arm,1 fistulas in each arm respectively. Conclusion Arterio- venous fistula aneurysm is related to localised puncture site, post dialysis haemostasis, atherosclerosis and so on.