动静脉内瘘不同手术方式对血液透析病人心功能的影响
Effect of different surgical methods in the treatment of arteriovenous fistula on cardiac function in hemodialysis patients
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摘要: 目的:探讨动静脉内瘘不同手术方式对血液透析病人心功能的影响。方法:选择行动静脉内瘘术治疗的尿毒症病人60例,其中端-端吻合、端-侧吻合各30例,观察病人动静脉内瘘及心功能情况,评价动静脉内瘘不同手术方式对病人心功能的影响。结果:端-侧吻合组术后平均血流量和平均直径均高于端-端吻合组(P<0.01);端-侧吻合组术后1年心指数明显上升,射血分数明显下降,与端-端吻合组差异均有统计学意义(P<0.01);2组内瘘失败发生率差异均无统计学意义(P>0.05)。结论:对选择动静脉内瘘手术治疗的血液透析病人,端-侧吻合是一种既能确保透析血流量,又不会增加病人心脏负荷的一种手术方式,值得推广。Abstract: Objective:To investigate the effects of different surgical methods in the treatment of arteriovenous fistula on cardiac function in hemodialysis patients.Methods:Sixty uremic patients were treated with end-to-end arteriovenous fistula anastomosis(30 cases) and end-to-side arteriovenous fistula anastomosis(30 cases).The arteriovenous fistula and heart function in all patients were observed,and the effects of different surgical methods on cardiac function were evaluated.Results:The postoperative average blood flow and diameter in end-to-side anastomosis group were higher than those in end-to-end anastomosis group(P<0.01).After 1 year of operation,the cardiac index significantly increased,and the ejection fraction significantly decreased in end-to-side anastomosis group,and the differences of the cardiac index and ejection fraction between two groups were statistically significant(P<0.01).The difference of the incidence rate of the fistula failure between two groups was not statistically significant(P>0.05).Conclusions:The end-to-side anastomosis in the treatment of arteriovenous fistula in hemodialysis patients can ensure the blood flow,does not increase the heart load,which is worthy of promotion.
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Key words:
- hemodialysis /
- arteriovenous fistula /
- cardiac function
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