血管移植在难建性透析通路中的应用

为研究生物性（人尸血管、同种异体及自体大隐静脉脉）和非生物性血管（ｅＰＴＦＥ）移植在难建性透析动静脉内瘘中的作用，采用多种血管材料对２００例尿毒症患者前臂和上臂作袢式、直桥式、间插式及跨跃式移植建立永久性血管透析通路。结果移植血管中人造血管１１２例，人尸血管７８例，同种异体大静脉１９例，自体大隐静脉１１例。一次手术成功率９９．１％，非生物性血管移植１年通畅率９６．４％，２年通畅率９２％，３年通畅率

Vascular Graft Applied to Patients with Difficulty to Construct Hemodialysis Access

In this paper,we used biological (cadaveric blood vessel,homologous or autogeneic saphenous veins) or non-biological vascular (expanded polytetrafluoroethylene,ePTFE) grafts to construct hemodialysis access,the vascular grafts were placed in the forearm or the upper arm for permanent hemodialysis access in 220 uremic patients.Of the 220 patients,112 accepted ePTFE grafts,78 accepted human cadaver's vascular grafts,19 accepted homologous saphenous veins grafts and 11 accepted autogeneic saphenous veins grafts.The results indicated that the successful rate of operation was 99 1%.The patent rates of ePTFE at 1st,2nd,3rd year were 96 4%,92% and 87 5% respectively;The patent rates of biological grafts at 1st,2nd,3rd year were 90 7%,86 1%,81 5% respectively;The common complications were thrombosis(9 5%),aneurysm(2 7%) and infection (2 3%) respectively.The findings suggest that the vascular grafting is a good approach for constructing dialysis access in patients with difficulty to establish direct arterio-venous fistulas in hemodialysis.