改良端侧吻合结合机械及液压扩张法在动静脉内瘘术中应用观察.docVIP

改良端侧吻合结合机械及液压扩张法在动静脉内瘘术中应用观察 　　【摘要】 目的：探?尿毒症晚期需血液透析患者采用改良端侧吻合结合机械和液压扩张法的动静脉内瘘术的效果，为临床提供高效、安全的手术方法。方法：选取2013年1月-2017年2月本院要做血液透析的尿毒症晚期患者70例作为研究对象，其中2013年1月-2015年6月40例患者采用传统端侧吻合内瘘术为对照组，2015年7月-2017年2月30例采用改良端侧吻合结合机械及液压扩张法动静脉内瘘术为观察组，以术后3个月为观察期，比较两组吻合管径、头静脉血流量、手术优良率、成功率、术后并发症发生情况。结果：观察组的吻合管径、头静脉血流量、手术优良率均优于对照组（P0.05）；观察组发生内瘘管血栓、手肿胀、吻合口狭窄等并发症均明显低于对照组，仅吻合口狭窄差异有统计学意义（P0.05）。结论：尿毒症晚期血液透析患者改良端侧吻合结合机械及液压扩张法动静脉内瘘术，具有提高手术成功率、并发症发生率低等临床特点，同时能够改善静脉条件较差患者的静脉管径，加强内瘘的血流量，保证透析治疗的成功率。 　　【关键词】 改良端侧吻合； 机械； 液压扩张法； 动静脉内瘘术 　　【Abstract】 Objective：To investigate the effect of improved end-to-side anastomosis combined with mechanical and hydraulic expansion method in internal arteriovenous fistula surgery of uremic late hemodialysis patients， so as to provide an efficient and safe surgical procedure for the patients. Method：70 cases of advanced uremia with hemodialysis from January 2013 to February 2017 were selected as the subjects.40 patients with traditional end-to-side internal anastomosis fistula from January 2013 to June 2015 were chosen as the control group.30 patients with improved end-to-side anastomosis combined with mechanical and hydraulic expansion method in arteriovenous fistula surgery from July 2015 to February 2017 were chosen as the observation group. 　　3 months after surgery was the observation period. The anastomotic diameter， head venous blood flow， excellent and good rate， success rate and postoperative complications of two groups were compared. Result：The anastomosis diameter， head venous blood flow and excellent operation rate of the observation group were better than those of the control group （P0.05）. The occurrence of internal fistula thrombosis， swelling of the hand， anastomotic stenosis and other complications in the observation group were significantly lower than the control group，the anastomotic stenosis was different （P0.05）.Conclusion：The improved end-to-side anastomosis combined with mechanical and hydraulic dilation arteriovenous fistula in patients with