标准动静脉内瘘的手术效果分析

目的探讨提高标准动静脉内瘘开放率的方法,分析内瘘早期失败的原因。方法收集了226例终末期肾衰尿毒症患者在行标准动静脉内瘘术的术前准备、手术操作、并发症的处理和术后护理方面所采取的综合措施,计算术后6周累积初级开放率、累积次级开放率和内瘘失败率,分析内瘘早期失败的原因。结果术后6周累积初级开放率为85.4%（193/226）,累积次级开放率为92.5%（209/226）,内瘘早期失败率为7.5%（17/226）,失败的主要原因是血栓形成（10例）和瘘口狭窄（7例）。结论本组所采取的综合性措施有助于提高标准动静脉内瘘手术的开放率。血栓和狭窄是内瘘早期失败的主要原因,糖尿病、肥胖、低血压、瘦弱、老年和女性患者易发生早期内瘘失败。

Analysis of result of the surgical operation of standard primary arteriovenous fistula

Objective To explore the method for increasing the patency rate of primary arteriovenous fistula（AVF） and analyze the reasons of the earlier fail of AVF.Methods The prepare before operation,the surgical operation,the treatment of complications and the measure of the nursing of 226 cases surgical operation of the standard primary AVF were retrospectively analyzed.The first-level accumulation patency-rate,the second-level accumulation patency-rate,and the failure rate of AVF at the 6th week after operation were accounted,and the reasons of failure AVF in earlier period were analyzed.Results The first-level accumulation patency-rate was 85.4%（193/226）,the second-level accumulation patency-rate 92.5%（209/226） and the failure rate was 7.5%（17/226）.The main reason of failure of AVF was thrombosis（10 cases） and stenosis（7cases）.Conclusion The comprehensive measures are helpful in improving the patency-rate of primary AVF.The main reason of earlier failure of AVF is thrombosis and stenosis.