改良侧侧吻合技术在动静脉瘘成形术中运用分析.docVIP

改良侧侧吻合技术在动静脉瘘成形术中运用分析 　　[摘要] 目的 探讨改良侧侧吻合技术在动静脉瘘成形术的临床运用效果分析。方法 2012年2月―2015年10月选取该院收治的64例慢性肾衰竭患者随机分为两组，各32例。常规组采用端端吻合术创建动静脉血管内瘘，改良组采用改良侧侧吻合动静脉瘘吻合术，均采用连续锁边缝合法。对比两组患者动静脉瘘直径、血流、成功率等。 结果 改良组的吻合口直径、血流量与常规组相比有显著性差异（P0.05）；改良组吻合成功率91.3%，高于常规组的69.6%，差异有统计学意义（P0.05）。改良组并发症发生率4.34%，显著低于对照组的21.74%（P0.05）。结论 改良侧侧吻合技术施行头静脉与桡动脉吻合术者，吻合口血管开口增大，血流增多，静脉血管明显扩张，内瘘成熟度提高。成功率明显高于端端吻合的血管内瘘，提高手术成功率及内瘘成熟率。结论 改良侧侧吻合技术能够扩大吻合口直径，增加血流流量，减少并发症，并缩短内瘘成熟时间，提高手术成功率。 　　[关键词] 改良侧侧吻合术；动静脉瘘；端端吻合 　　[中图分类号] R6 [文献标识码] A [文章编号] 1674-0742（2016）04（a）-0036-03 　　[Abstract] Objective To discuss and analyze the clinical effect of modified side-to -side anastomosis in the application of AVF plasty. Methods 64 cases of patients with chronic renal failure treated from February 2012 to October 2015 were randomly divided into two groups with 32 cases in each， the conventional group adopted end-to-end anastomosis for establishing arterio-venous fistula， the modified group adopted modified side-to-side anastomosis， both groups adopted interlocking suture， and the diameter of arteriovenous fistula， blood flow and successful rate were compared between the two groups. Results There were obvious differences in the diameter of anastomosis and blood flow between the modified group and the conventional group by comparison，（P0.05）， the success rate of anastomosis in the modified group was higher than that in the conventional group（91.3% vs 69.6%）， and the difference had statistical significance（P0.05）， the incidence rate of complications in the modified group was obviously lower than that in the control group（4.34% vs 21.74%）（P0.05）. Conclusion Modified side-to-side anastomosis can enlarge the diameter of anastomosis， increase blood flow， reduce complications， shorten the mature time of internal fistula and improve the success rate of operation. 　　[Key words] Modified side-to -side anastomosis； Arteriovenous fistula； End-to-end anastomosis 　　动静脉瘘指动脉和静脉之间存在异常通道，是进行血液透析的必要条件。其中内瘘可长期、反复穿刺，且无皮肤外露，感染率低，成为临床上首选血液透析方式[1]。一直以来，提