关键词: 尿毒症患者, 股部, 人工血管移植动静脉内瘘术, 血液透析

Abstract:

[Abstract] Objective: To investigate the method and necessity of establishing arteriovenous fistulations with artificial vessel transplantation in the thigh for hemodialysis when routine vascular access can not be established on the upper limb vessels in patients with uremia. Methodology: From July 2011 to March 2014, fifteen uremic hemodialysis patients on the right thigh establishing bypass graft fistula with artificial vessel in the shares ( shallow) artery - saphenous vein were enrolled into this retrospective study. The bypass graft fistula surgical approach summary and use of effects was evaluated. Results: They were 6 males and 9 females with an average age of 54.3 years old. The operation of bypass graft fistula with artificial vessel was successful without complications, the use of postoperative fistula patency was good, and the hemodialysis blood flow was amounted to 230ml/min or more. They were fllowed up for 3-34 months, one patient thrombosis occurs after six months of operation, successful embolectomy, thrombectomy again and failed after anther six months, at last indwelling half permanent catherter to hemodialysis .One case of seroma formation over six months underwent surgical removal, but does not affect the use of the fistula . Multiple linear regression analysis: the UF rates, Systolic Pressure, Serum Phosphorus. CHOL and TG were the independent risk factors for thrombosis occurs. The differences was statically significant (P<0.05). Conclusion: The artificial vascular graft choiced femoral vascular access was a new, effective and practical method if the uremic patients with no good upper extremity vascular conditions. Reduce UF rates, void hypotension, control of blood hyperviscosity syndrome and hyperphosphatemia can decrease the thrombosis of fistula .

Key words:  uremic patients, thigh , Arteriovenous Fistulations with Artificial Vessel transplantation, hemodialysis