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依据Harder提出的在腕关节远端制作动静脉内瘘,以延长尿毒症患者的生命线和高伟首创用钛轮钉为透析患者制备一个较好的内瘘的理论实践,我院自1993年应用钛轮钉建立手鼻烟壶动静脉内瘘74例,获得满意疗效,现总结如下。临床资料 74例均为终末期肾功能不全患者。女性30例,男性44例,年龄16～70岁,平均37岁。均采用国产内瘘吻合器,轮钉内径2.5mm者62例,2.0mm者12例,术后内瘘成功者66例,8例因动脉硬化,高凝等因素而失败。内瘘使用有效率86.8%。方法均采用局麻,在手鼻烟壶桡动脉搏动最明显处做1.5～2.0cm纵切口,依次游离出头静脉和桡动脉,分支予以结扎,将其远心端分别切断结扎。近心端分别挂至轮钉小齿上,二者抱合后端端吻合。漏血处用0/5无损伤缝线加固缝合。体会手鼻烟壶内瘘是上肢最远的内痿,位肢末
According to Harder made in the distal wrist distal arteriovenous fistula to prolong the lifeline of patients with uremia and Gao Wei’s first use of titanium wheels for dialysis patients to prepare a better fistula theory and practice in our hospital since 1993 Titanium wheel nail to establish hand snuff bottle arteriovenous fistula in 74 cases, obtained satisfactory curative effect, are summarized as follows. 74 cases of clinical data of patients with end-stage renal insufficiency. 30 females, 44 males, aged 16 to 70 years, an average of 37 years old. Domestic fistula staplers were used. There were 62 cases with 2.5mm diameter and 12 cases with 2.0mm diameter. Sixty-six cases with successful internal fistula and 8 cases with arteriosclerosis and hypercoagulability failed. Fistula use efficiency of 86.8%. Methods Local anesthesia was performed. The longitudinal incision of 1.5 ~ 2.0 cm was performed in the most obvious place of pulse of radial artery of hand snuff bottle. The cephalic vein and radial artery were dissociated in turn. The branches were ligated and their distal ends were severed and ligation respectively. Near the end of the heart were linked to the nail on the nail, the two anastomosis end anastomosis. Leakage at 0/5 without injury suture reinforcement suture. Experience hand snuff fistula is the farthest atrophy of the upper extremities limbs