动静脉内瘘术中应用硬膜外导管对内瘘功能的影响

目的探讨在动静脉内瘘术中应用硬膜外导管对内瘘功能的影响。方法将2008年6月至2009年12月行动静脉内瘘成形术97例，按手术方式不同分为，对照组（A组，46例）采用常规动静脉造瘘和治疗组（B组，51例）手术过程中采用硬膜外导管扩张及探查，测定两组患者内瘘术后4w时血流量、内瘘成熟率及1年内瘘血栓形成率。结果A组内瘘术后4w时血流量为（452．4±15．4）ml／min，内瘘成熟率为84．8％，1年内瘘血栓形成率为10．9％；B组内瘘术后4w时血流量为（480．6±16．8）ml／min，内瘘成熟率为96．1％，1年内瘘血栓形成率为13．7％。2组内瘘术后4w时血流量及内瘘成熟率差异具有统计学意义（P〈0．05）。结论在动静脉内瘘成形手术过程中，应用硬膜外导管探查及扩张，能增加内瘘术后4周时血流量，提高内瘘成熟率，且不增加1年内内瘘血栓发生率。

Effect of epidural catheter on function of internal arteriovenous fistula

Objective To investigate the effect of epidural catheter on function of internal arteriovenous fistula. Methods From August 2008 to December 2009, 97 cases of urinaemia receiving internal arteriovenous fistula operation were divided into two groups randomly. Group A （controls, n = 46） was subjected to routine method. In group B （catheters, n= 51 ）, cephalic vein was expanded by epidural catheter during operation. Volume of blood flow and maturing rate of fistula 4 weeks after operation, and thrombosis rate within one year were measured. Results Volume of blood flow and maturing rate of fistula 4 weeks after operation, and thrombosis rate within one year in group A and group B were （452. 4± 15. 4） ml/min, 84. 8% and 10. 9%, and （480. 6± 16. 8） ml/min, 96. 1% and 13. 7%, respectively. There was significant difference in volume of blood flow and maturing rate of fistula 4 weeks after operation between group A and group B（P〈0. 05）. Conclusions The application of epidural catheter exploration and expansion during internal arteriovenous fistula operation can increase volume of blood flow and maturing rate of fistula 4 weeks after operation, and it has no influence on thrombosis rate within one year postoperation.