合理结扎副头静脉对动静脉内瘘早期失功发生的影响研究
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摘要
目的观察结扎副头静脉对血液透析患者动静脉内瘘的桡动脉及头静脉内径、血流量以及早期失功率的影响。方法选择2015年9月~2017年9月在本院行动静脉内瘘术并维持血液透析的患者60例,随机分为实验组与对照组,给予实验组有选择性合理结扎副头静脉,观察12周后实验组与对照组患者的桡动脉、头静脉内径及血流量,对比两组患者差异。并观察早期失功例数,统计早期失功率,比较两组差异。结果实验组桡动脉及头静脉内径、血流量均高于对照组,两组比较差异有统计学意义(P<0.05);同时,实验组的早期失功率及肿胀手发生率低于对照组,两组比较差异有统计学意义(P<0.05)。结论对部分副头静脉进行合理结扎,有效地减少了患者的早期失功率,并可能起到一定程度的保护心功能作用,宜进一步进行探索和研究并推广应用于临床。
Objective To observe the effects of ligation of the accessory cephalic vein on the diameter of radial artery,the diameter of the cephalic vein, the blood flow and the early dysfunction rate of arteriovenous fistula in hemodialysis patients. Methods 60 patients who underwent venous fistula surgery and maintained hemodialysis in our hospital from September 2015 to September 2017 were selected and randomLy divided into experimental group and control group.The experimental group was given selective reasonable ligation of the accessory cephalic vein.The radial artery, the diameter of the cephalic vein and the blood flow in the experimental group and the control group were observed after 12 weeks, and the differences between the two groups were compared. The number of early dysfunction was observed, and the rate of early dysfunction was calculated, and the differences between the two groups were compared. Results The diameter of the radial artery and the cephalic vein and blood flow in the experimental group were significantly higher than those in the control group, and the difference was statistically significant(P<0.05). At the same time, the early dysfunction rate and hand swelling rate in the experimental group was lower than that in the control group, The difference between the two groups was also statistically significant(P <0.05). Conclusion Reasonable ligation of some accessory veins can effectively reduce the early dysfunction rate of patients and may play a role in protecting cardiac function,which should be further explored, studied and promoted in the clinical.
Objective To observe the effects of ligation of the accessory cephalic vein on the diameter of radial artery,the diameter of the cephalic vein, the blood flow and the early dysfunction rate of arteriovenous fistula in hemodialysis patients. Methods 60 patients who underwent venous fistula surgery and maintained hemodialysis in our hospital from September 2015 to September 2017 were selected and randomLy divided into experimental group and control group.The experimental group was given selective reasonable ligation of the accessory cephalic vein.The radial artery, the diameter of the cephalic vein and the blood flow in the experimental group and the control group were observed after 12 weeks, and the differences between the two groups were compared. The number of early dysfunction was observed, and the rate of early dysfunction was calculated, and the differences between the two groups were compared. Results The diameter of the radial artery and the cephalic vein and blood flow in the experimental group were significantly higher than those in the control group, and the difference was statistically significant(P<0.05). At the same time, the early dysfunction rate and hand swelling rate in the experimental group was lower than that in the control group, The difference between the two groups was also statistically significant(P <0.05). Conclusion Reasonable ligation of some accessory veins can effectively reduce the early dysfunction rate of patients and may play a role in protecting cardiac function,which should be further explored, studied and promoted in the clinical.
引文
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[15]康韬.动静脉内瘘对透析患者右心功能的影响[J].中国处方药,2015,13(3):25-26.
[2]童进东,谭德炎,田众一,等.腕部头静脉的解剖研究在动静脉内瘘成形术中的应用[J].中国中西医结合肾病杂志,2015,16(6):510-512.
[3]童进东,田众一,赖碧红,等.前臂失功动静脉内瘘修复的临床研究[J].中国中西医结合肾病杂志,2015,16(5):414-417.
[4]胡学芹,陈文,庄新鸿.120例两种动静脉内瘘术的临床效果分析[J].中国实用医药,2013,8(36):132-134.
[5]熊慧,叶君红,刘秀娟,等.湿热敷联合人工压力冲击法对早期失功动静脉内瘘的影响[J].中国血液净化,2017,16(2):141-142.
[6]单福军,李鑫宇,齐卡,等.2285例动静脉内瘘术在血液透析中的应用[J].中国中西医结合肾病杂志,2013,14(7):620-621.
[7]王春光,孙文奎,李晓咪,等.维持性血液透析患者桡动脉头静脉造瘘术前超声检测头静脉分支的临床意义[J].山东医药,2016,56(16):82-83.
[8]黄玲,彭小梅.动静脉内瘘狭窄及血栓形成的危险因素及预防[J].内科,2017,12(3):332-351.
[9]叶晓敏,骆芬霞,黄兴华.自体动静脉内瘘失功的临床分析[J].现代实用医学,2012,24(5):509-511.
[10]周忠信,潘春球.终末期肾病自体动静脉内瘘术后狭窄的手术修复策略[J].南方医科大学学报,2013,33(10):1538-1540.
[11]王栋,魏明明,刘雷,等.248例血液透析患者动静脉内瘘术式比较[J].中国中西医结合肾病杂志,2014,15(6):502-503.
[12]吴佳君,贺海东,胡屏,等.副头静脉对前臂动静脉内瘘早期失功的影响[J].中国血液净化,2017,16(7):491-493.
[13]Haq NU,Albaqumi M.Accessory vein obliteration criteria for immature fistulae:A modest proposal for an old paradigm[J].Semin Dial,2014,27(5):E51-E54.
[14]庄兆红.预行丝线环缩术对血透患者内瘘血流量及心功能影响的研究[J].现代诊断与治疗,2016,27(9):1712-1713.
[15]康韬.动静脉内瘘对透析患者右心功能的影响[J].中国处方药,2015,13(3):25-26.