头静脉与桡动脉显微吻合内瘘术42例体会

目的 总结并报道42例动静脉内瘘显微手术的方法和效果。方法 回顾性分析42例终末期肾功能衰竭患45次采用的不同手术方法的临床资料。结果 在前臂行端侧吻合21例，侧侧吻合3例，在鼻咽窝处行端端吻合19例，行端侧吻合2例。均能保证透析中血流量要求，一次手术成功38例，成功率90．5％。结论 根据患的不同情况，选择适当的手术方式，可以提高内瘘手术的成功率。

Clinical analysis of 42 internal arteriovenous fistulas

Objective To report 42 cases the microsurgical method and clinical effect with internal arteriovenous fistulas. Methods The approach and effect with different internal arteriovenous fistulas were analyzed in this retrospective study. Results 42 patient with end stage renal disease, there were 45 operation, the internal arteriovenous fistulas were performed operation with microsurgical method. In 21 cases, the artery side and vein extremity were connected with stitch method in the forearm, 3 cases side - side were connected. In 19 cases, the artery extremity and vein extremity were connected with stitch method in the carpal position of distant heart, 2 cases side - extremity were connected . The hemodialysis blood flow reached the usual standard. 38 cases (90.5 % ) succeed after operation only one time. conclusion The microsurgical method should be chosen according to patient clinical features, it will improve success rate of internal arteriovenous fistula.