改良动静脉内瘘术在150例慢性肾衰血液透析患者中的应用

目的：探讨动静脉内瘘的手术方法并观察其临床效果。方法：对150例慢性肾衰患者（其中糖尿病患者20例）和改良动静脉内瘘术：动脉做纵向梭形切口，静脉管腔用肝素盐水稍加压后冲洗，吻合后血管表面滴注罂粟碱。结果：本组150例患者均一次手术成功。术后血液透析中的平均血流量为252ml/min。内瘘平均启用时间为术后12d，对于30例因动静脉内瘘处形成血栓、利用原来的头静脉行二次手术的患者，手术后2d-3d开始启用，血液透析效果满意。结论：动脉做纵向梭形切口不易发生吻合口狭窄，静脉管腔用肝素盐水稍加压冲洗可以扩大管腔，吻合后血管表面滴注罂栗碱可缓解血管痉挛。改良后的动静脉内瘘术有利于提高手术成功率。

Application of improved method of operation of arteriovenous fistula in 150 cases of CRF hemodialysis

Objective:To probe into the improvement of operation on arteriovenous fistula.Methods:150 cases of chronic renal failure with hemodialysis in which include 20 cases of diabetes were done arteriovenous fistula operation.It is important to keep radial artery for portrait shuttle shape,to enlarge vein cavity by heparin saline water flashing and to drop papaverine on the surface of vascular.Results:All operations were successful.Average fistula flow was 252 ml/min during hemodialysis.The fistula was punctured about 12 days after operation.30 cases were done the second fistula operation upon primary fistula obstructed by thrombus.The fistular was used 2-3 days after operation.Hemodialysis was satisfactory.Conclusion:This method is good for successful operation of arteriovenous fistula.