中国组织工程研究Issue(30)：4911-4916,6.DOI:10.3969/j.issn.2095-4344.2014.30.025
聚四氟乙烯人工血管节段植入挽救流出道狭窄动静脉内瘘的效果分析
Polytetrafluoroethylene segment implantation for arteriovenous internal fistula with outflow tract obstruction
张愚 1朱志强 1郑鑫 1马雪涛 2刘建威 1韩志友2
作者信息
- 1. 首都医科大学附属北京佑安医院泌尿外科，北京市 100069
- 2. 北京中医药大学东直门医院泌尿外科，北京市 100700
- 折叠
摘要
Abstract
BACKGROUND:Arteriovenous internal fistula is the first choice for hemodialysis. In the process of hemodialysis, many patients suffer from venous outflow stenosis. The methods including thrombolysis, intervention, surgical repair and fistula reconstruction al have their disadvantages. OBJECTIVE:To compare the midterm effects of polytetrafluoroethylene segment implantation and exclusively surgical repair in arteriovenous internal fistula with outflow tract obstruction. METHODS:Eighty patients with venous outflow stenosis, aged 22-80 years, were divided into test group (n=50;polytetrafluoroethylene segment implantation) and control group (n=30;simple surgical repair). The post-operative infection rate, postoperative time til recurrence of fistula dysfunction, and accumulate survival rate were compared between the two groups. RESULTS AND CONCLUSION:During the fol ow-up period of 10-28 months in the test group, there were nine patients with vascular access dysfunction, and the accumulate survival rate was 100%for 6 postoperative months, 92%for 12 months, and 82%for 18 months. In the control group, there were seven cases of vascular access dysfunction at 8-28 months of fol ow-up, and the accumulate survival rate was 93%for 6 postoperative months, 87%for 12 months, and 77%for 18 months. No statistical y significant difference in the postoperative infection rate was observed between the two groups. The Kaplan-Meier survival curves showed that the accumulate survival rate was slightly higher in the test group than the control group, but there was no significant difference based on log-rank test (P=0.44). These findings indicate that polytetrafluoroethylene segment implantation for arteriovenous internal fistula with outflow tract obstruction has the similar effects as the surgical repair if it does not alter the autologous behavior of the initial access and maximal y reserve the vessels for puncture.关键词
生物材料/材料相容性/聚四氟乙稀/尿毒症/血管通路/人工血管/血液透析Key words
blood vessel prosthesis/uremia/renal dialysis分类
医药卫生引用本文复制引用
张愚,朱志强,郑鑫,马雪涛,刘建威,韩志友..聚四氟乙烯人工血管节段植入挽救流出道狭窄动静脉内瘘的效果分析[J].中国组织工程研究,2014,(30):4911-4916,6.
