鼻烟窝和前臂自体动静脉内瘘手术并发症分析.docVIP

鼻烟窝和前臂自体动静脉内瘘手术并发症分析 　　[摘要] 目的 比较鼻烟窝和前臂自体动静脉内瘘手术术后并发症发生情况。 方法 方便选取2010年7月―2013年7月该院收治的86例尿毒症患者，根据随机数字表法将86例尿毒症患者随机分为观察组（43例）和对照组（43例），观察组行前臂动静脉?瑞?手术，对照组实施鼻烟窝动静脉?瑞?手术。记录并比较术后两组患者初始血流量、成熟时间、透析时间等临床疗效以及3年内累计并发症发生情况。 结果 两组患者在平均吻合口径[（3.2±1.2）VS（2.4±1.2）]、初始血流量[（192.3±45.3） vs （188.3±42.5）]以及通畅率（80.41%vs80.73%）等临床指标差异均无统计学意义（P0.05）；对照组患者的动脉瘤发生率显著高于观察组（P0.05； 25%vs 17.4）；对照组血管迂曲扩张发生率显著高于观察组（P0.05， 10%VS4.34%）。 结论 前臂动静脉?瑞?手术比鼻烟窝内瘘可显著降低动脉瘤和血管迂曲扩张等并发症的发生率。 　　[关键词] 动静脉?瑞?；鼻烟窝?瑞?；前臂?瑞?；血管迂曲扩张 　　[中图分类号] R654.4 [文献标识码] A [文章编号] 1674-0742（2016）04（a）-0068-02 　　[Abstract] Objective To compare the occurrence of complications after the snuff-box and forearm native arteriovenous fistula operation. Methods 86 cases of patients with uremia admitted and treated in our hospital from July 2010 to July 2013 were selected and randomly divided into two groups with 43 cases in each， the observation group were treated with forearm arteriovenous fistula operation， the control group were treated with snuff-box arteriovenous fistula operation， the clinical curative effects such as initial blood flow， ripening time and dialysis time and occurrence of cumulative complications within 3 years were recorded and compared between the two groups after operation. Results The differences in the clinical indexes such as average anastomotic bore [（3.2±1.2） vs （2.4±1.2）]， initial blood flow [（192.3±45.3） vs （188.3±42.5） ] and patency rate （80.41% vs 80.73%） were not obvious， P0.05， the incidence rate of aneurysm in the control group was obviously higher than that in the observation group， P0.05， （25% vs 17.4%）， the incidence rate of tortuous dilation of blood vessel in the control group was obviously higher than that in the observation group， P0.05， （10% vs 4.34%）. Conclusion Compared with snuff-box arteriovenous fistula operation， the forearm arteriovenous fistula operation can obviously reduce the incidence rates of complications such as the aneurysm and tortuous dilation of blood vessel. 　　[Key words]