158例次人工血管动静脉内瘘术后并发症与长期通畅率

发布时间：2018-11-17 13:16

【摘要】：目的评价终末期肾病患者采用人工血管建立动静脉内瘘(AVG)的长期通畅率、术后并发症及处理。方法对2012年4月至2016年7月在本中心行AVG术的155例患者的病例资料进行回顾性分析。观察术后并发症的情况和统计术后初级通畅率、辅助初级通畅率及次级通畅率。结果本组患者共建立158例次AVG,技术成功率为100%。围术期死亡率为0,平均随访时间18.9(3~56)个月。初级通畅期平均13.6(1~37)个月,1年初级通畅率为72.13%,1年辅助初级通畅率为83.61%,1年次级通畅率为98.36%。2年初级通畅率为43.10%,2年辅助初级通畅率为44.83%,2年次级通畅率为93.10%。随访期间内,149例患者术后出现不同程度的肢体肿胀,3.2周左右消退。55例患者发生内瘘狭窄(121例次),38例患者血栓形成(61例次)。38例患者和15例患者分别出现Ⅰ期和Ⅱ期窃血综合征。假性动脉瘤4例,感染2例。结论 AVG术后并发症整体可控,经过积极处理也具有较高的次级通畅率,是无法建立AVF时重要的替代选择。但是AVG长期初级通畅率目前并不高,随访维护成本较高,AVG术前应对患者和家属进行充分告知,使其对AVG有合理的预期。
[Abstract]:Objective to evaluate the long-term patency rate, postoperative complications and management of arteriovenous fistula (AVG) in patients with end-stage nephropathy. Methods the data of 155 patients undergoing AVG from April 2012 to July 2016 were retrospectively analyzed. The primary patency rate, secondary patency rate and secondary patency rate were observed. Results the success rate of AVG, technique was 100 times. The perioperative mortality was 0 and the mean follow-up time was 18.9 (3 / 56) months. The primary patency rate in one year was 72.13, the primary patency rate in one year was 83.61, the secondary patency rate in one year was 98.36.2, the primary patency rate in one year was 43.10. The primary patency rate was 44.83, and the secondary patency rate was 93.10. During the follow-up period, 149 patients developed various degrees of limb swelling, which subsided around 3.2 weeks, and 55 patients suffered from internal fistula stenosis (121 times). 38 patients had thrombosis (61 times), 38 patients and 15 patients had stage 鈪，

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