静脉造影评估上肢动静脉内瘘成形术前静脉血管的价值

目的 探讨上肢静脉造影在评估拟行上肢动静脉内瘘患者静脉的价值. 方法 对中山大学附属中山医院血管外科2012年6月～2014年1月行动静脉内瘘术的89例尿毒症患者中21例行上肢静脉造影,根据术前上肢静脉造影结果选择目标血管后,行动静内瘘成形术,术后常规予以扩血管、抗血小板治疗.结果 所有21例患者均顺利完成检查,共发现36条适合建立内瘘的静脉.4例行前臂动静脉内瘘成形术,手术成功率100％,1期内瘘通畅率100％,8例行肘窝动静脉内瘘成形术,手术成功率100％,1期内瘘通畅率100％,9例行人工血管动静脉内瘘,手术成功率100％,1期内瘘通畅率100％.结论 上肢静脉造影在术前评估行动静内瘘成形术的静脉是非常有价值的方法,可发现临床上比较隐蔽的可适合的静脉,值得临床应用.

Preoperative venography for evaluating upper limb veins in patients before arteriovenous fistula surgery

Objective To study the value of preoperative venographic mapping in patients who require arteriovenous fistulas.Methods From June 2012 to Jan.2014,venography was performed in 21 uremia cases.Arteriovenous fistula was then created based on the venography image.Vasodilators and anti-platelet therapy were administered postoperatively.Results Arteriovenous fistulas were successfully accomplished in the 21 cases.A total of 36 veins were found to be suitable for arteriovenous fistula.In the 21 cases,4 forearm arteriovenous fistulas,8 elbow arteriovenous fistulas,and 9 arteriovenous fistula grafts were created with surgical success rate of 100％ and primary patency rate of 100％.Conclusion Venography is a useful tool for venous mapping prior to vascular access surgery.It can identify clinically occult veins usable for hemodialysis access,and is worthy of clinical application.