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为研究生物性 (人尸血管、同种异体及自体大隐静脉 )和非生物性血管 (ePTFE)移植在难建性透析动静脉内瘘中的作用 ,采用多种血管材料对 2 2 0例尿毒症患者前臂和上臂作袢式、直桥式、间插式及跨跃式移植建立永久性血管透析通路。结果移植血管中人造血管 112例 ,人尸血管 78例 ,同种异体大隐静脉 19例 ,自体大隐静脉 11例。一次手术成功率 99 1% ,非生物性血管移植 1年通畅率 96 4 % ,2年通畅率 92 % ,3年通畅率87 5% ;生物性血管 1～ 3年通畅率分别为 90 7%、86 1%、81 5%。主要并发症是血栓形成占 9 5% ,动脉瘤2 7%和感染 2 3%。说明移植血管内瘘为建立直接动静脉内瘘困难的尿毒症患者提供了一种安全、有效的永久性透析血管通路。
To investigate the role of biological (human cadaveric, allogeneic, and autologous saphenous vein) and non-biological vessel (ePTFE) transplants in intractable dialysis arteriovenous fistulas, a variety of vascular materials were used to evaluate the effects of uremia Patients with forearm and upper arm for plexiglass, straight bridge, interventricular and leaping transplants to establish a permanent vascular dialysis access. Results There were 112 cases of grafts, 78 cases of human corpse vessels, 19 cases of allograft saphenous vein and 11 cases of autologous saphenous vein. The success rate of one operation was 99.1%, one year patency rate of non-biological vascular graft was 96.4%, two-year patency rate was 92% and three-year patency rate was 87.5%. The biological patency rates of 1-3 years were 90.7% , 86 1%, 81 5%. The main complications were 95% of thrombosis, 27% of aneurysms and 23% of infections. It shows that transplanted vascular fistula provides a safe and effective permanent dialysis vascular access for uremic patients who have difficulty in establishing direct arteriovenous fistula.