大口径自体动静脉内瘘在糖尿病慢性肾衰透析通路中的运用

目的 探讨大口径自体动静脉内瘘在糖尿病慢性肾衰患者透析通路中的运用.方法 将86例糖尿病慢性肾功能衰竭分为老年组和非老年组,各组内再随机平均分配到实验组和对照组,均行腕部自体动静脉内瘘成形术,术式为头静脉与桡动脉端侧吻合;实验组桡动脉纵向切开约1.0cm～1.1 cm,对照组0.7 cm～0.8cm.结果 手术成功率实验组(90.9%、95.2%)明显高于对照组(77.3%、85.7%),差异有统计学意义(P<0.05),无1例发生心衰.结论 糖尿病慢性肾功能衰竭患者在行自体动静脉内瘘成形术时,可适当增加吻合口内径,即可满足血液透析对血流量的需求,又不至于引起心功能衰竭.

The application of larger-bore autologous arteriovenous fistula as dialysis pathways in diabetes patients with chronic renal failure

Objective To observe and discusses the application of larger-bore autologous arteriovenous fistula as dialysis pathways in diabetes patients with chronic renal failure. Methods 86 cases of diabetic patients with chronic renal failure were divided into elderly group and non-elderly group. The patients within each group were assigned randomly into Experimental subgroup and control subgroup. Patients underwent wrist autogenous arteriovenous fistula angioplasty.The surgical method was end to side anastomosis between cephalic vein and radial artery. Vertical incision on the radial artery is about 0.7 cm-0.8 cm in the control subgroup and vertical incision on the radial artery is about 1.0 cm-1.1cm in the experimental subgroup. Results The success rate of the operation in experimental subgroup(90.9%, 95.2%) was significantly higher than that of control group(77.3%, 85.7%). The differences were significant (P<0.05). There was no heart failure in the patients underwent surgery. Conclusions In diabetes patients with chronic renal failure need autogenous arteriovenous fistula angioplasty. Properly increasing the diameter of anastomosis can meet the demand on blood flow of hemodialysis without increase complication of heart failure.