'降落伞式'缝合技术在鼻烟窝动静脉内瘘中的应用

摘要

目的 探讨"降落伞式"连续缝合技术(PSRS)在鼻烟窝桡动脉-头静脉内瘘(RCF)中的应用.方法 回顾性分析42例尿毒症患者PSRS行鼻烟窝RCF的资料.结果 左鼻烟窝造瘘36例,右鼻烟窝造瘘6例,手术时间45～120 min,出血5～30 mL.所有患者术后扪及震颤,39例术后5～6周经内瘘行透析,3例术后6周内瘘血流量低于220 mL/min,均为女性,其中2例为糖尿病肾病患者,1例为高血压肾病患者.结论 鼻烟窝内采用PSRS行RCF可确保吻合口的质量,大大降低吻合的难度,提高造瘘成功率.%Objective To explore the application of parachute-style running suture( PSRS ) during end-to-side anastomosis for radio-cephalic fistulae( RCF ) in anatomical snuff-box. Methods There were 42 cases of uremia who admitted the procedures of RCF with end-to-side anastomosis in anatomical snuff-box, and whose data were analyzed retrospectively. Results There were 36 cases who had RCF in left anatomical snuff-box, and 6 cases in right anatomical snuff-box. The operating time was 45120 minutes, and the bleeding volume was 530 mL. All patients were palpated tremor along cephalic veins after operation. 39 cases had routine dialysis from RCF 6 weeks after operations, and 3 cases whose RCF was dysfunctional, among whom 2 cases had diabetic nephropathy and 1 had hypertensive nephropathy. Conclusion It is favorable to have RCF in anatomical snuff-box with PSRS, which can decrease difficulty of anastomosis and improve the success of RCF.