支撑导管联合改良端侧吻合法在前臂桡动脉-头静脉内瘘手术中的应用

目的探究支撑导管在前臂桡动脉-头静脉内瘘(RC-AVF)手术中的应用及其价值。方法回顾性分析2020年6月至10月在连云港市第一人民医院行RC-AVF手术造瘘60例患者的临床资料。采用改良端侧吻合法的30例为对照组,在对照组基础上联合支撑导管的30例为试验组,分析比较两组术中相关指标、动静脉内瘘相关指标及使用情况、术后6个月内并发症情况。结果试验组术中血管吻合时间显著短于对照组(P<0.01);首次透析血流量、术后8周引流静脉内径、肱动脉血流量均优于对照组(P<0.05,P<0.01);术后6个月内试验组并发症发生率较对照组有所降低,但差异无统计学意义(7.14%vs 26.92%,P>0.05)。结论在RC-AVF术中使用支撑导管行血管吻合可以不剥离血管外膜,从而减少手术损伤、降低血管吻合难度,且支撑导管成本低廉,获取及使用方便。

Application of supporting catheter combined with modified end-to-side anastomosis in RC-AVF operation

Objective To explore the application value of supporting catheter in the operation of radial artery-cephalic vein fistula(RC-AVF)of forearm.Methods The clinical data of 60 patients who underwent RC-AVF operation in the First People's Hospital of Lianyungang from June to October 2020 were analyzed retrospectively.Thirty cases of modified end-to-side anastomosis were used as the control group,and 30 cases of combined support catheter on the basis of the control group were used as the experimental group.The intraoperative related indexes and use of AVF and complications within 6 months were analyzed and compared between the two groups.Results Compared with the control group,the time of intraoperative vascular anastomosis was significantly shortened in the experimental group(P<0.01);the blood flow of the first dialysis,the inner diameter of the drainage vein and the blood flow of brachial artery 8 weeks after the operation were better than those of the control group(P<0.05,P<0.01).The incidence of complications in the experimental group was lower than that in the control group within 6 months after operation,but the difference was not statistically significant(7.14%vs 26.92%,P>0.05).Conclusions In RC-AVF operation,the use of supporting catheter for vascular anastomosis can not peel off the vascular adventitia,thereby reducing the surgical injury and the difficulty of vascular anastomosis.In addition,the supporting catheter has the advantages of low cost and convenient acquisition and use.