关键词: 贵要静脉转位, 动静脉内瘘, 血液透析, 充分性, 并发症

Abstract:

【Abstract】Objective：To compare dialysis adequacy and complications between hemodialysis patients using autologous arteriovenous fistula with forearm basilic vein transposition vs. those using standard arteriovenous fistula as blood access, and to explore the significance of autologous arteriovenous fistula with forearm basilic vein transposition in patients with maintenance hemodialysis．Methodology：Eighty six patients with maintenance hemodialysis were selected in this retrospective study from October 2010 to September 2012. They were divided into two groups according to the establishing way of arteriovenous fistula: one group was given the newly established autologous arteriovenous fistula with forearm basilic vein transposition (A group, n=13) and the other group given a newly created standard fistula (B group, n=73) .The age, dialysis blood flow, ejection fraction within one month before the end of observation, Kt/V, fistula maturation time, blood access life-span, the length of fistula vein puncture, complications, and death occurrence were compared between two groups during a follow-up period of 13-37 months. The operation method for A group was forearm basilic vein transposition with tiny incision for arteriovenous fistula. Results：There was no significant difference in age, dialysis blood flow, blood access life-span, the ejection fraction before and after operation, the length of fistula vein puncture, Kt/V, blood access life-span, the mortality rate between two groups（P＞0.05）. The operation time, fistula maturation time, and anticoagulation rate were higher in the A group than that in the B group, those differences were statistically significant（P<0.05）. No complications such as the hand swelling syndrome, stolen blood syndrome, and limb ischemia were observed, and also no adverse effects on the patients’ cardiac function were found. Conclusions： Both of two groups can achieve adequate dialysis, and the complications are less. Autologous arteriovenous fistula with forearm basilic vein transposition is a good alternative blood access for maintenance hemodialysis patients when the standard arteriovenous fistula is unable to establish.

Key words: Basilic vein transposition, Arteriovenous fistula, Hemodialysis, Dialysis adequacy, Complications