血管移植在血液透析中的应用

目的：研究生物性血管（人尸血管、同种异体及自体大隐静脉）和非生物性血管（ＰＴＦＥ）移植，在血液透析中的作用。方法：采用多种血管材料对２２０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，同种异体大隐静脉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１～３年畅率分别为９７．３％，９２％，８７．

APPLICATION OF VASCULAR GRAFT IN PATIENTS WITH DIFFICULTY IN ESTABLISHING DIRECT ARTERIO-VENOUS FISTULAS IN HEMODIALYSIS

To explore the application of biological (cadaveric vascular homologous or autogenous saphenous veins)or nonbiological vascular (expanded polytetrafluoroethylene,ePTFE) grafts for hemodialysis access. METHODOLOGY Vascular grafts were placed in the forearm or the upper arm for permanent hemodialysis access in 220 uremic patients. RESULTS Of the 220 patients,112 recieved ePTFE grafts,78 recieved human cadaveric vascular grafts,19 recieved homologous saphenous vein grafts and 11 recieved autogenous saphenous vein grafts.The success rate of operation was 99 1%.Patency rates of ePTFE at the end of the lst,2nd,3rd year were 90 7%,92% and 87 5% respectively,Patency rates of biological grafts at the end of the lst,2nd,3rd year were 90 7%,86 1% and 81 5% respectively.The common complications were thrombosis(9 5%),aneurysm(2 7%)and infection(2 3%). CONCLUSION Vascular graft is a good alternative for constructing dialysis access in patients with difficulty in establishing direct arterio venous fistulas in hemodialysis